| Objective: Through the analysis of 30 patients with cystic lung cancer confirmed by pathology,to investigate the imaging manifestations of cystic lung cancer with multi-slice spiral CT(MSCT)and to compare it with pathology,and to summarize the imaging manifestations,pathological types and correlation of cystic lung cancer.To deepen the understanding of cystic lung cancer and to provide the basis for clinical diagnosis and treatment.Methods: Retrospective analysis was performed on 30 cases of primary cystic lumen lung cancer confirmed by postoperative pathology or biopsy in our hospital from January 2017 to October 2020.SIEMENS 16-slice spiral CT or Philip 64-slice spiral CT were used.All data are post-processed and reconstructed in the workstation.Histopathological results showed that 22 cases were adenocarcinoma,7 cases were squamous cell carcinoma,and 1 case was mucoepidermoid carcinoma.According to the pathological types,they were divided into two groups: adenocarcinoma group(22cases)and squamous cell carcinoma group(7 cases).The clinical data,MSCT manifestations and pathological features were analyzed.Normal distribution measurement data were expressed as mean and standard deviation(x± s),independent sample t test was used for comparison between groups,frequency and percentage were used for counting data,and the comparison of counting data was analyzed by Chi-square test or Fisher’s exact probability method.P < 0.05 was considered statistically significant.Results:(1)Clinical characteristics :in this study,a total of 30 patients with cystic lumen lung cancer were collected,including 22 males(73%)and 8 females(27%),ranging in age from 35 to 82 years old,with an average age of(60.23±13.53)years.Fifteen patients were asymptomatic and found incidentally.Sixteen patients had a smoking history,and 11 patients had emphysema.(2)Pathological features: Among the30 patients collected,22 were adenocarcinoma,7 were squamous cell carcinoma,and 1was mucoepidermoid carcinoma.The pathological types of adenocarcinoma and squamous cell carcinoma showed no statistical significance in lesion morphology,lobulation sign,burr sign,pleural involvement sign,vascular cluster sign,bronchial air sign,vascular crossing sign,cystic wall thickness,nodule or partition,and cystic cavity number in the two groups(P >0.05).There was statistical significance in the mean size of lesions and cystic lumen(P <0.05).The mean size of lesions and cystic lumen in squamous cell carcinoma group was larger than that in adenocarcinoma group.(3)MSCT manifestations: The lesions were located in the upper lobe of the right lung in 7cases,the middle lobe of the right lung in 4 cases,the lower lobe of the right lung in 9cases,the upper lobe of the left lung in 3 cases,and the lower lobe of the left lung in 7cases.There were 18 cases of irregular shape(60%),12 cases of circular shape(40%),26 cases of lobulated shape(87%),13 cases of burr(43%),6 cases of bronchial air filling sign(20%),20 cases of pleural involvement sign(67%),and 23 cases of vascular cluster sign(77%).The density of ground glass was 3 cases(10%),mixed ground glass density was 6 cases(20%),and solid glass density was 21 cases(70%).There were 16 cases of single cyst(53%)and 14 cases of multiple cysts(47%).There were internal separation in 21 cases(70%),vascular passage in 6 cases(20%),incomplete cyst wall in 26 cases(87%),and uneven thickness of cyst wall in 28 cases(93%).18 cases(60%)were associated with nodules.The size of the lesions ranged from 11.05 mm to 61.40 mm,with an average size of(24.00±12.33)mm.The cystic size ranged from 5.30 mm to 49.90 mm,with an average size of(14.69±11.16)mm.In contrast CT scan,1 case was mildly enhanced,7 cases were moderately enhanced,and2 cases were significantly enhanced.(4)Follow-up characteristics:At follow-up,the cyst was enlarged in 2 of 6 patients,and the cyst was reduced or disappeared in 4patients.There were 2 cases of new mural nodules.Three patients had enlarged nodules,one had reduced nodules,and two of them became solid nodules.Conclusion: 1.Multi-slice spiral CT has certain advantages in the detection of cystic luminal lung cancer.2.Cystic lumen lung cancer is more common in the middle-aged and elderly,and adenocarcinoma is more common.3.It has the characteristics of general peripheral lung cancer,such as lobulation,burr,pleural involvement,vascular aggregation,etc.,and also has some characteristic manifestations,such as bronchial crossing sign,vascular crossing sign,mural nodules,uneven thickening of the cyst wall,uneven wall thickness,and compartment in the cyst.4.The average size of lesions and cystic lumen on MSCT is significant for the differentiation of adenocarcinoma and squamous cell carcinoma.5.Dynamic follow-up is of great value for the diagnosis of diseases,and the possibility of benign and malignant diseases can be judged according to cystic cavity,cystic wall and wall nodules.It is helpful for early diagnosis,reducing the rate of missed diagnosis and misdiagnosis,and providing basis for clinical diagnosis and treatment. |
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