纵隔型肺癌的CT诊断

目的探讨纵隔型肺癌与纵隔肿瘤的临床与CT鉴别要点。方法回顾性分析12例经病理证实的纵隔型肺癌的临床与CT表现。结果纵隔型肺癌属于晚期肺癌,发病年龄高(平均发病年龄60岁);多数患者出现声音嘶哑、膈肌麻痹、上腔静脉综合征或锁骨上窝淋巴结肿大;肿块侵犯纵隔胸膜处之纵隔胸膜脂肪线消失、瘤肺界面模糊;发生于右肺上叶的纵隔型肺癌,在CT轴位扫描时常出现“V”字征。结论纵隔型肺癌是指肺原发癌临近纵隔或原发于纵隔内的左右主支气管长大后侵犯纵隔胸膜或与纵隔内肿大淋巴结融合成块,常被误诊为原发纵隔肿瘤或纵隔转移瘤。CT扫描对二者的鉴别诊断有重要参考价值。

CT diagnosis of mediastinum-typed lung cancer

Objective To explore the clinical manifestations of mediastinum-typed lung cancer and its differential gist from other mediastinal tumors.Methods The clinical data and CT findings of 12 patients with pathologically proved mediastinum-typed lung cancer were analyzed retrospectively.Results The mediastinum-typed lung cancer was referred to as late lung cancer.Pathogenetic age of patients was frequently of old age (mean 60 years),and most patients clinically presented hoarseness,paralysis of diaphragm,superior vena cava syndrome or lymphonodus enlargement in supraclavicular fossa.When carcinous mass infiltrated into mediastinal pleura,it could make whose fatty line disappear and have an ill-defined interface between the mass and lung.The mediastinum-typed lung cancer arising from upper lobe of the right lung frequently presented a V-typed sign on CT axial images.Conclusion The mediastinum-typed lung cancer can be defined as primary lung cancer near mediastinum or originated from left and right main bronchi in mediastinum.Following these masses′ continued growth and development,they can infiltrate into the mediastinal pleura or produce the confluence with swelling lymphonodi in mediastinum and become mass-form so that it is frequently misdiagnosed as primary mediastinal tumor or mediastinal metastasis.CT scanning can provide an important reference for differentiating the both above-mentioned.