MSCT sings of neuroendocrine tumors of the lung and their relationship with ACTH-ectopic syndrome.

Buryakina S.A., Karmazanovsky G.G, Volevodz N.N., Pikunov M.Yu, Tarbaeva N.V., Ko-valevich L.D.

Purpose. Evaluation of MSCT signs of neuroendocrine tumors (NET) using dynamic contrast enhanced MSCT and their comparison with the presence of ACTH-ectopic syndrome, as well as with literature data. Materials and methods. MSCT scan was performed in 41 patients with NET: "Typical carcinoid" (TC) (16 patients), "atypical carcinoid" (AC) (7), "large cell neuroendocrine lung cancer" (LCNEC) (4) and "small cell neuroendocrine lung cancer" (SCLC) (14). 39 patients underwent contrast enhanced MSCT. Localization, shape, size, surrounding parenchyma, pleura, pleural effusion, association with bronchus and vessel, presence of necrosis and cal-cifications, size of the largest regional lymph node, density in all phases, “perfusion” and “T/A ratio” were analyzed. CT signs were compared with ACTH syndrome. Results. Necrosis was typical for AC (sensitivity 28.6%, specificity 100% and overall accuracy 78.2%). Ectopic ACTH syndrome was revealed in 9 (56.3%) patients with TC and in 2 (28.6%) patients with AC. Size less than 12.5 mm, "perfusion" less than 0.86 ml / min / ml and "T/A ratio " less than 36.8% were related to a ACTH-producing carcinoid. Conclusions. Carcinoid can be suspected if round or oval lesion, with clear, smooth or tuberous contours, intensively accumulating a contrast media, was detected. If necrosis was detected, AC can be suspected. Small size, low "perfusion" and "T/A ratio" are typical for ACTH-producing carcinoids. If the lesion has tuberous or fuzzy contours, calcifications and necrosis, invasion in bronchus, neuroendocrine cancer can be suspected. It is impossi-ble to differentiate the LCNEC and SCLC.
1 - A.V. Vishnevsky National Medical Research Centre of Surgery. 2 - National Medical Re-search Centre of Endocrinology. Moscow, Russia

 

 

Keywords: ectopic ACTH syndrome, MSCT, neuroendocrine tumor, lung, carcinoid tumor.

Corresponding author: Buryakina S.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

For citation: Buryakina S.A., Karmazanovsky G.G, Volevodz N.N., Pikunov M.Yu, Tarbaeva N.V., Kovalevich L.D.MSCT sings of neuroendocrine tumors of the lung and their relationship with ACTH-ectopic syndrome. REJR 2018; 8(4):56-72. DOI:10.21569/2222-7415-2018-8-4-56-72.

Received:16.09.18Accepted:23.11.18