Objective To study the correlation between clinical manifestation,imaging features and pathology of pulmonary neuroendocrine carcinomas with extrapulmonary manifestations as the first symptom. In order to improve the ability of early diagnosis and treatment of pulmonary neuroendocrine carcinomas. Methods A retrospective analysis was used to analyze the clinical data of 41 cases with nerve endocrine symptoms as the first clinical manifestation of primary lung cancer. We analyzed the correlation factors of the clinical manifestations,imaging features and pathological results by statistical methods. Results The first symptom of 41 cases of pulmonary neuroendocrine carcinomas were: backache(21 cases), numbness of limbs(5 cases),abdominal pain(3 cases),inguinal mass(3 cases),dysphagia(2 cases),mandibular mass(2 cases), weakness of limbs(2 cases),hyponatremia(2 cases),acropachia(1 case).The imaging features of pulmonary neuroendocrine carcinomas were: central type(27 cases),lobulated(32 cases),long or short burr(33 cases),lymphatic metastases(29 cases).The pathological types of pulmonary neuroendocrine carcinomas were: small cell lung cancer(27 cases,66%),carcinoid(9 cases,22%),large cell lung cancer (5 cases,12%). Conclusion The clinical manifestation and imaging features of pulmonary neuroendocrine carcinomas with extrapulmonary manifestations as the first symptom has no specificity,the definitive diagnosis requires lung biopsy.%目的 探讨首发为肺外表现的肺神经内分泌肿瘤的临床表现、影像学表现及病理诊断的相关性,提高对此类疾病早诊断、早治疗的能力.方法 回顾性分析41例以神经内分泌等症状为首发临床表现的原发性肺癌的临床相关资料.采用统计学方法对临床表现、影像学表现、病理结果等相关因素进行分析.结果 41例肺神经内分泌肿瘤主要首发症状:腰背痛(21例)、肢体麻木(5例)、腹痛腹胀(3例)、腹股沟肿块(3例)、吞咽困难(2例)、下颌部肿块(2例)、四肢乏力(2例)、低钠血症(2例)、杵状指(1例);影像学特征:中央型(27例),分叶状(32例),长或短毛刺(33例),淋巴结转移(29例);病理类型:小细胞肺癌27例,占66%;类癌9例,占22%;肺大细胞肺癌5例,占12%.结论 肺神经内分泌肿瘤的首发肺外临床表现、影像学表现无特异性,活检组织病理可明确诊断.
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