【呼吸系统】腺样囊性癌

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【腺样囊性癌】

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【病史】

45 / F；Palpable neck mass

45岁，女性；颈部触及肿块

【影像学检查】

图1 胸片正位

图2 胸部CT增强横断面

图3 胸部CT增强横断面

图4 胸部CT增强横断面

图5 胸部CT增强冠状面

图6 胸部MR T1WI横断面

图7 胸部MR T1W2横断面

图8 胸部MR T1WI增强横断面

图9 胸部MR T1W2冠状面

【影像学表现】

Fig 1. Chest radiograph shows mass-like increased opacity in mediastinum with thickening of right paratracheal stripe and mild shifting of tracheal lumen to the left side.

图1.胸片显示纵隔肿块样高密度影，右侧气管旁条状增厚，气管腔轻度向左移位。

Fig 2-4. Low attenuation mass around the trachea, nearly encircling the tracheal circumference. Focal intraluminal protruding lesion atright posterior portion of tracheal lumen (Fig2).

图2-4.气管周围低密度肿块，几乎包绕气管生长。气管腔右后部见局灶性腔内隆起性病变（图2）。

Fig 5. The longitudinal extent of the tumor is greater than its transaxial extent.
图5.肿瘤纵向范围大于横向。

Fig 6-9. Mass appears as low signal intensity (SI) on T1 weighted image (WI), high SI on T2 WI and homogenous enhancement. Focal nodular lesion invading intraluminally at the junction of cartilage andposterior membrane is noted, transluminal tumor with intraluminal and extraluminal growth pattern.
图6-9.肿块T1呈低信号，T2呈高信号，增强后均匀强化。局灶性结节侵犯软骨和气管后壁粘膜连接部，跨腔内外生长。

【诊断】

Biopsy via ultrasonography at the supraclavicular area revealed adenoid cystic carcinoma.
在锁骨上区超声引导下穿刺活检提示腺样囊性癌。

【影像学检查】

Adenoid cystic carcinoma,  occurs mainly in the salivary glands or central airways, such as the trachea and the main bronchi.
腺样囊性癌主要发生于唾液腺和中央气道，如气管和主支气管。

It is a low-grade malignancy that is the second most common tracheal malignancy at histology (33%) after squamous cell carcinoma (48%).

其为低级别恶性肿瘤，在组织学上第二常见的支气管恶性肿瘤，仅次于鳞状细胞癌。

Adenoid cystic carcinomas usually arise in the lower trachea. Others are found in the mainstem bronchi; lobar bronchi; or, rarely, in the segmental bronchi and extrathoracic trachea.
腺样囊性癌常起源于气管下部。部分见于主支气管、叶支气管；段支气管及胸腔外气管段罕见。

The tumor has a striking tendency toward submucosal extension that manifests as an intraluminal mass of soft-tissue attenuation with extension through the tracheal wall, a diffuse or circumferential wall thickening of the trachea, a soft-tissue mass filling the airway, or a homogeneous mass encircling the trachea with wall thickening in the transverse and longitudinal planes.
肿瘤具有向黏膜下浸润的显著趋势，表现为软组织密度的腔内肿块，并浸润穿过气管壁，气管壁弥漫性或环形增厚、气管被软组织肿块填充或均质的肿块包绕气管伴气管壁在横向和纵向上增厚。

The longitudinal extent of the tumor is greater than its transaxial extent.
肿瘤纵向范围大于横向。

Although the most common site of the tumor in the trachea has been reported to be the posterolateral wall, the anterolateral wall.
据报道，肿瘤最常发生于气管后侧壁及前侧壁。

mild shifting of ... to the left side:轻度向左移位
encircling v. 包围，环绕

luminal：官腔

intraluminal [ɪntræ'lu:mɪnəl] adj.管腔内的

salivary [səˈlaɪvəri] adj.唾腺;唾液的

感谢Eun Jin Chae, M.D. / Asan Medical Center, University of Ulsan College of Medicine

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