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目的探讨原发性肺涎腺肿瘤的临床特点及CT表现。方法搜集经手术、纤支镜及病理证实的19例原发性肺涎腺肿瘤患者的临床病理与CT资料,回顾性分析其CT表现及临床特点。结果 19例原发性肺涎腺肿瘤中,腺样囊性癌11例(57.9%)、黏液表皮样癌8例(42.1%)。19例均为中央型,发生于气管及段以上支气管。11例腺样囊性癌中,6例位于气管,3例位于主支气管,2例位于叶支气管;6例(54.5%)呈环壁浸润生长,5例(45.6%)呈浸润生长并局部结节状突向腔内,病灶密度均匀,增强扫描欠均匀强化;3例(27.3%)合并肺不张,3例(27.3%)伴有纵隔淋巴结肿大,1例(9.1%)并肺转移,1例(9.1%)出现肝、双肾转移。8例黏液表皮样癌均发生于段或段以上支气管;3例(37.5%)呈圆形,5例(62.5%)呈不规则形,病灶密度欠均匀;3例(37.5%)增强扫描明显强化,5例(62.5%)呈轻或中度强化;2例(25.0%)伴纵隔膈淋巴结肿大,3例(37.5%)并远端肺不张及黏液栓塞表现。结论原发性肺涎腺肿瘤好发于段以上中央气道,CT表现具有一定特征性。腺样囊性癌浸润生长表现明显,黏液表皮样癌可伴有支气管黏液栓塞表现。
Objective To investigate the clinical features and CT findings of primary salivary gland tumors. Methods The clinicopathological data and CT data of 19 patients with primary salivary gland tumors confirmed by operation, bronchoscopy and pathology were collected. The CT findings and clinical features were retrospectively analyzed. Results In 19 cases of primary salivary gland tumors, adenoid cystic carcinoma in 11 cases (57.9%) and mucoepidermoid carcinoma in 8 cases (42.1%). 19 cases were central, occurred in the trachea and above the bronchus. Of the 11 adenoid cystic carcinomas, 6 were located in the trachea, 3 in the main bronchus and 2 in the bronchioles; 6 (54.5%) were infiltrated by the circumferential wall and 5 (45.6%) were infiltrated with local knot In 3 cases (27.3%) with atelectasis, 3 cases (27.3%) had enlarged mediastinal lymph nodes and 1 case (9.1%) had lung metastases , 1 case (9.1%) appeared liver and kidney metastases. 8 cases of mucoepidermoid carcinoma occurred in the segment or above the bronchus; 3 cases (37.5%) were round, 5 cases (62.5%) were irregular shape, lesion density less uniform; 3 cases (37.5% (62.5%) showed mild or moderate enhancement. Two cases (25.0%) had enlarged mediastinal lymph nodes and three cases (37.5%) showed distal atelectasis and mucus embolism. Conclusions Primary salivary gland tumors occur in the central airway above the segment, and CT features have certain characteristics. Adenoid cystic carcinoma showed obvious infiltration of growth, mucoepidermoid carcinoma may be associated with bronchial mucus embolism.