摘要
目的 了解肺低分化腺癌的影像学表现特征及发病率的变化趋势。材料与方法 搜集 1989～ 1999年间肺低分化腺癌患者 186例 ,其中有影像学资料者 15 7例 ,包括胸片 14 6例 ;CT扫描 97例 ,其中平扫 5 8例 ,增强扫描 3 9例 ,肿瘤局部HRCT 15例。结果 ( 1)影像学表现 :①中央型病变 3 6例 ( 2 2 .9% ) ,其中腔内外生长的气管肿物 2例 ,腔内型病变 1例 ,肺门肿物及阻塞性改变 3 3例 ;伴广泛纵隔、肺门淋巴结肿大 5例。②周围型病变 12 1例 ( 77.1% ) ,最大径为 1～ 10cm ,中位值 4cm。病灶≥ 4cm者 76例( 62 .8% ) ,浸润性病变 5例 ( 4 .1% ) ,空洞 4例 ( 3 .3 % )。③跨叶 3 3例。④纵隔淋巴结肿大 45例 ( 2 9.0 % )。大团融合纵隔肿大淋巴结7例 ( 4 .5 % )。 ( 2 ) 1989～ 1999年间 ,腺癌占同期肺癌的 2 0 .4% ,肺低分化腺癌占同期肺腺癌的 14 .5 % ( 1979～ 1986年为 7.7% ,1989～1994年为 13 .1% ,1995～ 1999年为 17.0 % )。结论 ( 1)肺低分化腺癌中 ,仅少数 ( 2 9.0 % )为典型腺癌影像学表现 (小结节、分叶、毛刺 ) ,非典型表现者占 71.0 % ,包括中央型病变、周围型大肿物、浸润病变、空洞、跨叶。 ( 2 )CT示纵隔引流区成簇小淋巴结 ,应警惕有转移之可能。 ( 3 )本组肺腺癌在肺癌中所占比例和过去?
Objective To analyze the imaging manifestations of the poorly differentiated pulmonary adenocarcinoma and its changing trend in incidence.Materials and Methods Of 186 cases with proved poorly differentiated pulmonary adenocarcinoma encountered during 1989～1999, 157 had imaging materials, including chest film (n=146), plain CT scan (n=58), enhanced CT scan (n=39), and HRCT (n=15).Results (1) Imaging features: ① Central type (n=36, 22.9%), including tracheal involvement (n=2), main stem bronchus involvement (n=1), hilar mass with obstructive atelectasis or pneumonitis (n=33) or extensive mediastinal and hilar lymphadenopathy (n=5). ② Peripheral lesions were found in 121 cases (77.1%), with the lesion size ranging from 1～10cm (median 4cm), the lesion was ≥4cm in 76 cases. Of them, infiltrative lesion was seen in 5 cases (4.1%) and cavitation in 4 cases (3.3%). ③ Tumors extending across the interlobar fissure were found in 33 cases. ④ Mediastinal lymphadenopathy was seen in 45 cases (29%). (2) The trend of incidence: During 1989～1999, adenocarcinoma accounted for 20.4% of total pulmonary carcinomas, while poorly differentiated adenocarcinoma accounted for 14.5% of total pulmonary carcinomas. In contrast, the incidence percentage of poorly differentiated adenocarcinoma was 7.7% during 1976～1986, 13.1% during 1989～1994 and 17% during 1995～ 1999. Conclusion (1) Only a small portion (29%) of poorly differentiated pulmonary adenocarcinoma carries typical imaging features, presenting as small nodule with lobulation and spiculation, most of them has atypical signs, such as central type lesion, large peripheral mass, infiltrative lesion, cavitation and a mass extending across the interlobar fissure. (2) Metastases should be highly suspected when clustered small mediastinal lymph nodes are presented in the lymph draining area on CT scan. (3) The incidence of the poorly differentiated pulmonary adenocarcinoma is progressively increasing in the recent several decades.
出处
《临床放射学杂志》
CSCD
北大核心
2001年第6期419-423,共5页
Journal of Clinical Radiology
