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《Radiologic Practice》 2018-01
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Clinical analysis,CT features and prognosis of central and peripheral pulmonary sarcomatoid carcinoma

HU Qiong-jie;SUN Zi-yan;XIA Li-ming;Department of Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology;  
Objective:The purpose of this study was to investigate and summarize the clinical features,CT manifestations and its prognosis of pulmonary sarcomatoid carcinoma(PSC).Methods:The clinical data and CT images of 38 patients with pathologically confirmed PSC were analyzed retrospectively.The patients were divided into central type(n=7)and peripheral type(n=31).Results:The ratio of male-to-female of peripheral PSC(PPSC)was 28:3.The rate of cigarette smoking rate in central PSC(CPSC)was 42.86%,while 74.20%in PPSC(P0.05).There were five cases of CPSC happened in the lobar brochus with diameter more than 5 cm(71.43%).There were 20 tumors larger than 5 cm in PPSC,2 masses with translobar growth,4 cases with involvement of interlobar fissure.There were 26 cases(83.87%)in PPSC with thickened pleura,10 cases(32.26%)of them with invasion of the adjacent chest wall,6 cases(19.35%)with bone invasion.The sign of deep lobulation was identified in 24 cases(77.42%)in PPSC.All 38 cases exhibited heterogeneous mass with necrotic enlarged mediastinal and/or hilar lymph nodes,among which 2 cases with cavity.On contrast-enhanced CT scan,irregular ring/patchy enhancement were shown.The survival rate in central type of PSC was lower than peripheral type with significant difference(P=0.0070.01).Conclusion:Most cases of PSC are more likely happened in elderly male with smoking history,appearing as a large heterogeneous peripheral mass with lobulation sign and obvious inhomogeneous enhancement,and might be invading the adjacent chest wall and bone.The central type of PSC is relatively less than the peripheral type with poorer prognosis.
【CateGory Index】: R730.44;R734.2
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