肺癌囊性变的CT表现与病理学对照研究(附26例分析)

目的分析26例绝大部分囊性变肺癌及由其形成的薄壁空洞性肺癌的CT表现及其病理基础。方法对14例主要表现为薄壁空洞和12例表现为完全或绝大部分囊变的肺癌病例的不典型CT表现进行分析,并与其病理表现进行对照分析。结果该26例具有不典型CT表现的肺癌均有其一定的病理基础。其中14例CT表现为薄壁空洞和12例CT表现为完全或绝大部分囊变的肺癌中,病理光镜下17例可见有大片坏死区;4例薄壁空洞性和3例完全囊变的肺癌病理光镜下可见大量癌细胞合并多处小片坏死区,3例可见大量的间质纤维化并纤维增生与纤维组织的玻璃样变性。结论肺癌瘤体内坏死液化是肺癌形成空洞或囊性改变等不典型CT表现的主要成因。肺癌瘤体内大量间质纤维化并玻璃样变性是肺癌CT表现为囊性改变的另一成因。肺癌的不典型CT表现给鉴别诊断造成一定困难,尤其是薄壁空洞性肺癌。对于内壁不甚规则之薄壁空洞性病变,应警惕肺癌。

Comparative study between CT appearance of cystic changes of lung cancer and their pathology

Objection To analyse the CT appearance of lung cancer which appeared cave with thin wall or cystoid and their foundation of pathology.Method Analysed CT appearance of 14lung cancer cases with appeared cave with thin wall and12cases which was being cystoid completely or mostly and compared to their foundation of pathology.Results26lung cancer cases with un-typical CT appearance had their definite foundation of pathology,there were10cases which appeared with thin wall,7cases which was being cystoid completely or mostly,a great deal of putrescence could be found on their pathology,many little putrescence in4cancer cases which appeared cave with thin wall,3cases which were cystoid completely and multitudinous interstical fibrosis with fi-brous tissue hyperplasia and glass denaturalizati on of fibrous in3cases which were cystoid completely.Conclu sion The main cause that lung cancer appeared cave with thin wall or cystoid is putrescence and liquefaction in tumors,Another cause which lung cancer appeared cystoids is interstical fibrosis and glass denaturalizati on in tumors.Untypical CT appearance brought some difficulties on dif-ferential diagnosis,especially for appearance of caves with thin wall.If their interior wall are not regular the lung cancer should be suspected.