ObjectiveTo discuss the CT characteristics of combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC), and analyze the reasons for its misdiagnosis. MethodWe retrospectively analyzed the CT data of 7 patients diagnosed to have combined hepatocellular carcinoma and cholangiocarcinoma by postoperative pathological analysis between January 2009 and February 2015. We analyzed such characteristics as location, shape, density, enhanced features, surrounding invasion, mediastinal lymph node metastasis, cirrhosis and pyoperitoneum of the disease. ResultsThere were 7 tumors among the 7 patients. Plain scan showed slightly lower density nodules or masses. After the enhancement of arterial phase, 5 tumors showed obvious inhomogeneous enhancement but 2 mild marginal enhancement. During the portal venous phase and the delay stage, the regional degree of tumor foci was significantly decreased, but some regions sustained annular or nodular and patchy enhancement. Among the 7 cases, the portal vein was invaded in 2, bile duct in 1, lymph node metastasis in 2, cirrhosis in 1, and peritoneal effusion in 1. Preoperative diagnosis was correct in only 2 cases and the other 5 cases were misdiagnosed by CT. ConclusionsThe cHCC-CC possesses some characteristic appearances on CT. Analyzing the characteristics carefully combining with symptom and cytological examination of hydrothorax can reduce the incidence of misdiagnosis.
ObjectiveTo discuss the diagnostic value of multi-slice spiral CT for bronchial mucoid impaction in early central-type carcinoma of lung. MethodsWe used multi-planar reformat, maximum intensity projection and minimum intensity projection to observe the characteristics of 15 patients with bronchial mucoid impaction in early central-type carcinoma of lung treated between March 2010 and October 2013. The characteristics included location, shape and enhanced performance of the tumor and the bronchial mucoid impaction. All the cases were confi rmed by operation or pathology. ResultsAmong the 15 cases, 12 were squamous cell carcinoma and 3 adenocarcinoma; 8 occurred on the right and 7 on the left. All the tumors showed equal density and were enhanced moderately. Bronchial mucoid impaction showed low density, no enhancement, accompanied bronchiectasis and occurred in bronchi which were far from the tumor, and there were 9 cases of strip, 5 of fabrication, and 1 of nodositas or cystic carcinoma. ConclusionThe location and shape of tumor and bronchial mucoid impaction are displayed clearly by multi-slice spiral CT and enhancement scanning can differentiate tumor from bronchial mucoid impaction. Multi-slice spiral CT has important diagnostic value in bronchial mucoid impaction of primary lung cancer in its early stage.
ObjectiveTo discuss the CT characteristics of pleural lung cancer, and analyze the reason for misdiagnosis. MethodsThe CT data of 8 patients with pleural lung cancer confirmed by postoperative pathology and treated in Renshou People's Hospital and Fist Affiliated Hospital of Chongqing Medical University between January 2010 and December 2013 were retrospectively analyzed. ResultsAmong the 8 cases of pleural lung cancer, 6 occurred on the left and 2 on the right; there were 3 nodular and 5 irregular masses; 6 had uniform density and 2 had irregular focus and relatively lower density; 4 had osteolytic destruction of adjacent ribs; 6 had pleural effusion; and 5 had mediastinal lymph nodes enlargement, in which 1 had multiple lymph node metastasis of left lung hilum, left supraclavicular region and left axillary. All the 8 cases were enhanced moderately. ConclusionPleural lung cancer has certain featured manifestations on CT. Analyzing the features carefully, considering clinical symptoms, and cytological examination of hydrothorax can reduce the incidence of misdiagnosis.