Features of multislice spiral computed tomography in micropapil-lary-predominant lung adenocarcinomas / 中国肿瘤临床

ABSTRACT

Objective:To examine the features of multislice spiral computed tomography (MSCT) in micropapillary-predominant lung adenocarcinomas to improve the understanding of this type of lung cancer. Methods:The MSCT features of 18 cases with micro-papillary-predominant lung adenocarcinoma (micropapillary component>50%) confirmed by histopathology were analyzed retrospec-tively. Results:Among the 18 cases of lung cancer, 1 was diffuse, 3 were central, and 14 were peripheral lung cancer (PLC). The size of the adenocarcinomas in the 14 PLC cases ranged from 1.3 cm to 8.5 cm, with an average of 3.56 cm, including the size of 8 cases greater than or equal to 3 cm. Among the 18 cases, 13 were lobulated, 9 showed spicule signs, 7 showed pleural indentation signs, 5 had pleural adhesions, 1 had bronchial truncation (i.e., cut-off sign), and 4 were surrounded by obstructive inflammation. In addition, calcifi-cation was observed in one case, uneven density in two large lesions, air bronchus sign in four, and solid and ground-glass mixed densi-ty in two. Among the total number of cases, a variety of the measurable enhanced CT values (ΔCT) of lesions were found in 16, ranging from 13 HU to 80 HU, with an average of 47.5 HU, of which 15 were cases ofΔCT≥15 HU and 15 were cases ofΔCT≥20 HU. Pleu-ral thickening was observed in two cases with pleural effusion, and pleural metastasis in one case was confirmed by histopathology. One case with pleural effusion suffering pleural metastasis was confirmed. Ground-glass density nodules in both lungs were observed in one case, with a few bilateral pleural and pericardial effusions. Eight cases had mediastinal or hilar enlarged lymph nodes with uneven density enhancement, and lymph node metastasis was pathologically confirmed in six cases. Lymph node metastasis was found in four cases, but no apparent enlargement of lymph nodes in MSCT was observed. Conclusion:Micropapillary-predominant lung adenocarci-nomas were common in non-smoking elderly female patients, whose lung cancer cases were mostly PLC. The typical features of PLC include lobulation, spicule, and pleural indentation signs. Solid density ranked first in the PLC cases, with evident enhancement and high rate of lymph node metastasis.