From the Departments of Radiology (F.G., A.P., S.S., G.B.A., J.E.) and Pulmonary Critical Care Medicine (E.S., M.G.), NewYork Presbyterian and Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065; Departments of Pulmonary Medicine (J.B.) and Pathology (F.Z.), New York University Langone Health, New York, NY; and Department of Pathology, Northwell Health, New York, NY (A.B.).
Radiographics. 2023 Sep;43(9):e230045. doi: 10.1148/rg.230045.
Tracheobronchial neoplasms are much less common than lung parenchymal neoplasms but can be associated with significant morbidity and mortality. They include a broad differential of both malignant and benign entities, extending far beyond more commonly known pathologic conditions such as squamous cell carcinoma and carcinoid tumor. Airway lesions may be incidental findings at imaging or manifest with symptoms related to airway narrowing or mucosal irritation, invasion of adjacent structures, or distant metastatic disease. While there is considerable overlap in clinical manifestation, imaging features, and bronchoscopic appearances, an awareness of potential distinguishing factors may help narrow the differential diagnosis. The authors review the epidemiology, imaging characteristics, typical anatomic distributions, bronchoscopic appearances, and histopathologic findings of a wide range of neoplastic entities involving the tracheobronchial tree. Malignant neoplasms discussed include squamous cell carcinoma, malignant salivary gland tumors (adenoid cystic carcinoma and mucoepidermoid carcinoma), carcinoid tumor, sarcomas, primary tracheobronchial lymphoma, and inflammatory myofibroblastic tumor. Benign neoplasms discussed include hamartoma, chondroma, lipoma, papilloma, amyloidoma, leiomyoma, neurogenic lesions, and benign salivary gland tumors (pleomorphic adenoma and mucous gland adenoma). Familiarity with the range of potential entities and any distinguishing features should prove valuable to thoracic radiologists, pulmonologists, and cardiothoracic surgeons when encountering the myriad of tracheobronchial neoplasms in clinical practice. Attention is paid to any features that may help render a more specific diagnosis before pathologic confirmation. RSNA, 2023 Quiz questions for this article are available in the supplemental material.
气管支气管肿瘤比肺实质肿瘤少见，但可导致严重的发病率和死亡率。它们包括广泛的良恶性实体肿瘤，远远超出了更常见的病理情况，如鳞状细胞癌和类癌肿瘤。气道病变可能是影像学检查中的偶然发现，也可能表现为与气道狭窄或黏膜刺激、邻近结构侵犯或远处转移疾病相关的症状。尽管临床表现、影像学特征和支气管镜表现有很大的重叠，但对潜在鉴别因素的认识可能有助于缩小鉴别诊断的范围。作者回顾了涉及气管支气管树的广泛肿瘤实体的流行病学、影像学特征、典型解剖分布、支气管镜表现和组织病理学发现。讨论的恶性肿瘤包括鳞状细胞癌、恶性唾液腺肿瘤（腺样囊性癌和黏液表皮样癌）、类癌肿瘤、肉瘤、原发性气管支气管淋巴瘤和炎性肌纤维母细胞瘤。讨论的良性肿瘤包括错构瘤、软骨瘤、脂肪瘤、乳头状瘤、淀粉样变性瘤、平滑肌瘤、神经源性病变和良性唾液腺肿瘤（多形性腺瘤和黏液腺腺瘤）。熟悉各种潜在实体和任何鉴别特征，对于在临床实践中遇到众多气管支气管肿瘤的胸放射科医生、肺科医生和心胸外科医生应该是有价值的。在获得病理证实之前，会注意任何有助于做出更具体诊断的特征。RSNA，2023 本文的测验问题可在补充材料中找到。
