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食道小型細胞癌的放射線學徵象

Radiological Findings of Primary Small Cell Carcinoma of Esophagus

摘要


食道小型細胞癌(small cell ca, SCCA)為一罕見而預後極差的腫瘤,本篇報告共收集了10個食道SCCA病例,其中一病例有三個病灶,因此,共有12個病灶。有一病例合併左肺上葉的肺泡細胞癌,我們分析此10病例的胸部電腦斷層及食道鋇劑雙對此檢查,可將食道SCCA的放射線徵象分為三種類型:第一類型為黏膜下腫瘤合併淋巴結轉移。此類型共有六個病灶,佔50%;第二類型為黏膜破壞及食道壁變厚。此類型共有五個病灶,佔42%;第三類型為食道腔息肉樣腫瘤合併潰痬。此類型只有一個病灶,佔8%。由以上的分類,可發現食道SCCA具有以下幾種特性: 1.食道SCCA可與肺部的肺泡細胞癌同時發生。 2.食道SCCA可為多發性病灶且這些病灶具有不同類型放射線徵象。 3.食道SCCA的放射線學上徵象為多變化的(variable),有時無法與常見的食道癌做區分如具第二,三類型放射學徵象的食道SCCA。但當出現第一類型的放射學徵象時,即食道黏膜下腫瘤合併縱膈腔淋巴結轉移,甚至肝轉移時,食道SCCA必須列為第一別鑑診斷。

並列摘要


Primary small cell carcinoma of esophagus (SCCA) is a rare and poor prognostic tumor. We collected 10 cases of primary SCCA of esophagus, with total 12 lesions. One patient had triple SCCA at the same time and the other case, in addition, also had broncho-alveolar carcinoma in th lung. Analyzed the radiological findings of CT scan and double contrast study of esophagus of these 10 cases. There are three type of radiological findings grouping in our series: Type Ⅰ Submucosal tumor with mediastinal lymphadenopathy. (6 lesions; 50%) Type Ⅱ: Mucosal destruction with wall thickening. (5 lesions; 42%) Type Ⅲ : Intraluminal polypoid lesion with ulceration. (1 lesion; 8%) It is our conclusion that the radiological findings of the SCCA of esophagus are variable, but the type I is more specific for SCCA of esophagus.

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