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目的:总结胸腺类癌的临床表现、病理特征、CT表现及其临床价值。方法:对本院收治的2例胸腺类癌进行分析并结合文献复习。结果:胸腺类癌发病率低,大部分早期患者无临床症状,经胸部X线、CT检查时发现;中晚期始出现症状。病理检查出类癌后,电镜可见神经内分泌颗粒,免疫组化显示神经特异性烯醇化酶、肿瘤嗜铬蛋白A、促皮质素阳性。胸部CT表现特征为起于前上纵隔肿块,常位于心底部大血管和心包周围,肿块内密度不均,可见钙化,增强后轻中度强化,易发生胸内外转移。结论:胸腺类癌是一罕见的前纵隔肿瘤,根据CT特征,结合临床可有助诊断、指导手术、推测预后,因此CT在临床诊治中有非常重要的价值。
Objective: To summarize the clinical manifestations, pathological features, CT findings and clinical value of thymoma carcinomas. Methods: Two cases of thymoma carcinomas admitted to our hospital were analyzed and reviewed. Results: The incidence of thymus carcinoid was low, most of the early patients had no clinical symptoms, which were found by X-ray and CT scan of the thorax. Symptoms were found in the middle and late stage. Pathological examination of carcinoid after electron microscopy showed neuroendocrine granules, immunohistochemistry showed nerve specific enolase, tumor chromogranin A, corticotropin-positive. Chest CT features from the anterior mediastinum mass, often located in the bottom of the heart of the great vessels and pericardium, mass density within the uneven, visible calcification, enhanced mild to moderate enhancement, prone to intrathoracic and external metastasis. Conclusion: Thymic carcinoid tumor is a rare anterior mediastinum tumor. According to the CT features, it can be helpful to diagnose, guide the operation and predict the prognosis according to the CT. Therefore, CT is of great value in the clinical diagnosis and treatment.