单纯性细支气管肺泡癌的CT诊断

 目的　探讨单纯性细支气管肺泡癌的高分辨CT（HRCT）特点。方法　收集经病理证实的单纯性细支气管肺泡癌患者21例（22处病变）,对照术后病理进行回顾性分析。结果　术后病理结果非黏液产生型单纯性细支气管肺泡癌20例,21处病变,黏液产生型单纯性细支气管肺泡癌1例。野口分类：A型3例,B型12例,C型5例,黏液型未作分类。病期分类：21例均为ⅠA期,肿瘤最大径0.3～3.0 cm（平均1.3 cm）。全病例均无胸膜和脉管浸润,无淋巴结转移。HRCT所见：根据磨玻璃密度影（GGO）的含量多少,将病变分为4种类型,病变全部呈GGO为A型（5例）;GGO中心少量线状影为B型（7例）;GGO中心及周边线状影散在为C型（7例）;结节形成型为D型（3例）。伴有胸膜牵引11例。肿瘤境界清晰,边缘光整的病例5例,余17处病变边缘不规则,境界不清。阴影中心部伴有血管、支气管阴影者21例。结论　HRCT能够反映细支气管肺泡癌的病理组织学的结构特征,对于病理侵袭度的预测及预后评估起着重要的作用。

CT diagnosis of pure bronchioloalveolar carcinoma

Objective To explore the HRCT characteristics of solitary pure bronchioloalveolar carcinoma. Methods Compared with postop pathological appearance, 21 patients with 22 affections tumors which were pathologically confirmed pure bronchioloalveolar carcinoma were retrospectively reviewed. Results the histo- pathological results prior to surgery showed that 20 patients with 21 affections tumors were non-mucilaginous BAC and 1 patient was mucilaginous BAC. Noguchi＇s classification： Type A 3 cases, Type B 12 cases, Type C 5 cases. （Mucilaginous BAC was not classified） Stage classification： There were 21 cases with stage IA, the maximum tumor diameter was from 0.3 to 3.0 mm （average diameter 1.3 mm）. No case showed pleura metastasis, vessel invasion and lymphaticmetastasis. Appearance of HRCT： according to the amount of GGO, all affections were divided into 4 groups. A group （5/22）, B group （7/22）, C group （7/22）, D group （3/22）. There were 11 cases with pleura traction, 5 cases with clear boundary and trimmed edges and other 17 cases were contradistinction. There were 21 cases with blood vessel or bronchus shadow. Conclusion HRCT can show scan can provide details of structure characteristics of BAC＇s pathological histology, so it plays an important role in prediction of pathological infiltration of tumor cells and prognosis assessment.