Volume 21 Issue 7
Jul.  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(7): 1197-1201
CHEN Wu, SONG Biao, WANG Bin, LI Yuan, SONG Qilong, WANG Zhaohua, MIN Xuhong. CT imaging diagnosis of primary pulmonary mucinous adenocarcinoma[J]. Chinese Journal of General Practice, 2023, 21(7): 1197-1201. doi: 10.16766/j.cnki.issn.1674-4152.003083
Citation: CHEN Wu, SONG Biao, WANG Bin, LI Yuan, SONG Qilong, WANG Zhaohua, MIN Xuhong. CT imaging diagnosis of primary pulmonary mucinous adenocarcinoma[J]. Chinese Journal of General Practice, 2023, 21(7): 1197-1201. doi: 10.16766/j.cnki.issn.1674-4152.003083
shu

CT imaging diagnosis of primary pulmonary mucinous adenocarcinoma

doi: 10.16766/j.cnki.issn.1674-4152.003083

  • Medical Imaging Department of Anhui Chest Hospital, Hefei, Anhui 230000, China

Funds:

 Z155080000004

  • Received Date: 2023-03-26
    Available Online: 2023-08-28
    Abstract
  •   Objective  To investigate and summarize the CT imaging characteristics of primary pulmonary mucinous adenocarcinoma, diagnose the disease early through its imaging characteristics, and select appropriate treatment methods, so as to improve survival.  Methods  A total of 62 cases of pathologically confirmed primary pulmonary mucinous adenocarcinoma from August 2019 to August 2022 in Anhui Provincial Chest Hospital were selected, their clinical, imaging features and pathological results were retrospectively analyzed, and the imaging features of nodular/mass type and consolidation type of primary pulmonary mucinous adenocarcinoma were compared, and the imaging manifestations combined with pathological features were summarized.  Results  The age of onset of 62 patients was 14-80 years old, and the average age was (60.5±10.5) years. The main complaint was cough white phlegm. The imaging results showed that there were 46 cases of nodular/mass type in 62 patients, including 2 cases (4.3%) of pure ground-glass nodules, 22 cases (47.8%) of mixed ground-glass nodules, 22 cases (47.8%) of solid nodules and masses, 31 cases (67.4%) of subpleural (gravity-heavy parts) of the lower lobes of both lungs, 2 cases occurred in airway dissemination (4.3%), and other common signs included vascular cluster sign, vacuole/cavitation sign, etc. There were 16 cases of consolidation type, with 14 cases (87.5%) occurring under the pleura in the lower lobes of both lungs, 9 cases (56.3%) experiencing airway spread, and other common signs including vacuole/cavity sign, vascular floating sign, and dead tree branch sign. The pathological results showed that abundant mucus could be seen under the microscope, scattered in the heterotypic cell mass, and the immunohistochemistry showed: CK7(+) 43 cases, TTF-1(+) 51 cases, Napsin-A (+) 36 cases, Ki-67 (≤ 50%) 53 cases, and CDX-2 (+) 18 cases.  Conclusion  Primary pulmonary mucinous adenocarcinoma is generally divided into nodular/mass type and consolidation type, mainly distributed in the large position of gravity of lung lobes, light to moderate reinforcement after enhancement, pathological scattered around the heterotypic cell mass filled with mucus components, and immunohistochemical diagnosis commonly involves CK7(+) and TTF-1(+).

     

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    • References(19)
  • [1]
    HAN Y P, LUO Y J. Primary lung invasive adenocarcinoma misdiagnosed as infectious pneumonia in 18F-FDG PET/CT: a case report[J]. Radiol Case Rep, 2021, 17(3): 808-811.
    [2]
    李媛, 谢惠康, 武春燕. WHO胸部肿瘤分类(第5版)中肺肿瘤部分解读[J]. 中国癌症杂志, 2021, 31(7): 574-580. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGAZ202109001.htm

    LI Y, XIE H K, WU C Y. Interpretation of lung tumors in WHO classification of thoracic tumors (5th edition)[J]. Chinese Journal of Oncology, 2021, 31(7): 574-580. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGAZ202109001.htm
    [3]
    邵元伟, 滕敏敏, 王晓蕾, 等. 原发性肺浸润性黏液腺癌的临床病理特征与CT表现[J]. 中国临床医学影像杂志, 2020, 31(10): 719-722, 726. https://www.cnki.com.cn/Article/CJFDTOTAL-LYYX202010011.htm

    SHAO Y W, TENG M M, WANG X L, et al. Clinicopathological features and CT findings of primary pulmonary invasive mucinous adenocarcinoma[J]. Chinese Journal of Clinical Medical Imaging, 2020, 31(10): 719-722, 726. https://www.cnki.com.cn/Article/CJFDTOTAL-LYYX202010011.htm
    [4]
    包杰, 金银华, 华奇峰, 等. 结合病理对原发性肺粘液腺癌的MSCT表现分析[J]. 医学影像学杂志, 2020, 30(5): 871-874. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXZ202005042.htm

    BAO J, JIN Y H, HUA Q F, et al. Analysis of MSCT manifestations of primary pulmonary mucinous adenocarcinoma combined with pathology[J]. Journal of Medical Imaging, 2020, 30(5): 871-874. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXZ202005042.htm
    [5]
    孙伟, 于跃, 李俊, 等. 肺浸润性黏液腺癌的病理影像学特征及治疗方法应用研究进展[J]. 山东医药, 2022, 62(15): 103-107. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYY202215024.htm

    SUN W, YU Y, LI J, et al. Research progress on pathologic imaging features and therapeutic methods of pulmonary invasive mucinous adenocarcinoma[J]. Shandong Medical Journal, 2022, 62(15): 103-107. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYY202215024.htm
    [6]
    SHENG A Z, ZHOU P F, YE Y Z, et al. Diagnostic efficacy of CT radiomic features in pulmonary invasive mucinous adenocarcinoma[J]. Scanning, 2022, 2022: 5314225. DOI: 10.1155/2022/5314225.
    [7]
    杨昭, 王小雷, 李淑华, 等. CT影像组学列线图评估肺腺癌脏层胸膜侵犯[J]. 中国医学影像技术, 2022, 38(7): 1017-1022. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXX202207012.htm

    YANG Z, WANG X L, LI S H, et al. Identification of pleural invasion of the visceral layer of lung adenocarcinoma by CT radiomics[J]. Chinese Journal of Medical Imaging Technology, 2022, 38(7): 1017-1022. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXX202207012.htm
    [8]
    MIYATA N, ENDO M, NAKAJIMA T, et al. High-resolution computed tomography findings of early mucinous adenocarcinomas and their pathologic characteristics in 22 surgically resected cases[J]. Eur J Radiol, 2015, 84(5): 993-997.
    [9]
    张俊杰, 郝李刚, 许茜, 等. 基于临床及CT特征构建预测肺浸润性黏液腺癌的机器学习模型[J]. 中华全科医学, 2023, 21(1): 6-9, 49. doi: 10.16766/j.cnki.issn.1674-4152.002799

    ZHANG J J, HAO L G, XU Q, et al. Construction of a machine learning model for predicting lung invasive mucinous adenocarcinoma based on clinical and CT features[J]. Chinese Journal of General Practice, 2023, 21(1): 6-9, 49. doi: 10.16766/j.cnki.issn.1674-4152.002799
    [10]
    范真真, 高鹏. 肺炎型浸润性黏液型腺癌的CT和病理学特征分析[J]. 实用放射学杂志, 2022, 38(7): 1096-1099.

    FAN Z Z, GAO P. CT and pathological features of invasive mucinous adenocarcinoma pneumoniae[J]. Journal of Practical Radiology, 2022, 38(7): 1096-1099.
    [11]
    ZHOU C, ZHAO J K, SHAO J C, et al. Prognostic relevance of TTF-1 expression in stage I adenocarcinoma[J]. Oncotarget, 2017, 8(64): 107462-107468. DOI: 10.18632/oncotarget.22489.
    [12]
    刘标, 周晓军. 非小细胞肺癌免疫组化标志物专家共识(2014)[J]. 临床与实验病理学杂志, 2015, 31(5): 481-487. https://www.cnki.com.cn/Article/CJFDTOTAL-LSBL201505001.htm

    LIU B, ZHOU X J. Expert consensus on immunohistochemical markers for non-small cell lung cancer (2014)[J]. Journal of Clinical and Experimental Pathology, 2015, 31(5): 481-487. https://www.cnki.com.cn/Article/CJFDTOTAL-LSBL201505001.htm
    [13]
    王彩霞, 王晓, 吕淑慧, 等. TTF-1、SP-A在肺腺癌诊断及鉴别诊断中的价值[J]. 临床与实验病理学杂志, 2008, 24(3): 280-283. https://www.cnki.com.cn/Article/CJFDTOTAL-LSBL200803010.htm

    WANG C X, WANG X, LYU S H, et al. Value of TTF-1 and SP-A in the diagnosis and differential diagnosis of lung adenocarcinoma[J]. Journal of Clinical and Experimental Pathology, 2008, 24(3): 280-283. https://www.cnki.com.cn/Article/CJFDTOTAL-LSBL200803010.htm
    [14]
    韩高华, 周晓军, 孟奎, 等. TTF-1在肺腺癌中的表达及其诊断意义[J]. 临床与实验病理学杂志, 2002, 18(6): 595-597. https://www.cnki.com.cn/Article/CJFDTOTAL-LSBL200206004.htm

    HAN G H, ZHOU X J, MENG K, et al. Expression and diagnostic significance of TTF-1 in lung adenocarcinoma[J]. Journal of Clinical and Experimental Pathology, 2002, 18(6): 595-597. https://www.cnki.com.cn/Article/CJFDTOTAL-LSBL200206004.htm
    [15]
    XU X L, SHEN W M, WANG D, et al. Clinical features and prognosis of resectable pulmonary primary invasive mucinous adenocarcinoma[J]. Transl Lung Cancer Res, 2022, 11(3): 420-431.
    [16]
    NIE K, NIE W, ZHANG Y X, et al. Comparing clinicopathological features and prognosis of primary pulmonary invasive mucinous adenocarcinoma based on computed tomography findings[J]. Cancer Imaging, 2019, 19(1): 47.
    [17]
    留永健, 李霁, 王世波, 等. 晚期肺炎型肺癌: 一项中国单中心临床-放射-病理特征回顾性研究及预后分析[J]. 中国肺癌杂志, 2019, 22(6): 329-335. https://www.cnki.com.cn/Article/CJFDTOTAL-FAIZ201906001.htm

    LIU Y J, LI J, WANG S B, et al. Advanced pneumonic lung cancer: a retrospective study and prognostic analysis of single-center clinical-radiopathological features in China[J]. Chinese Journal of Lung Cancer, 2019, 22(6): 329-335. https://www.cnki.com.cn/Article/CJFDTOTAL-FAIZ201906001.htm
    [18]
    NAGASAKA M, POTUGARI B, NGUYEN A, et al. KRAS inhibitors- yes but what next? Direct targeting of KRAS- vaccines, adoptive T cell therapy and beyond[J]. Cancer Treat Rev, 2021, 101: 102309. DOI: 10.1016/j.ctrv.2021.102309.
    [19]
    WANG T T, YANG Y, LIU X Y, et al. Primary invasive mucinous adenocarcinoma of the lung: prognostic value of CT Imaging features combined with clinical factors[J]. Korean J Radiol, 2021, 22(4): 652-662.
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