支气管肺癌伴其它部位多原发癌的影像诊断(附25例报告)

经病理确诊的527例原发性支气管肺癌(PBC)(1972～1987)中,PBC伴其它部位多原发癌(MPC)25例(4.7％)。其中双原发肺癌(DPBC)、12例(2.3％),PBC伴消化道癌6例(1.14％)。25例中共有原发癌灶52个,其中2例为3原发癌;同期组6例(其中DPBC 4例),后期组19例(其中14例间隔3年以上,内2例分别间隔14年及25年)。组织类型相同者8例,不同者4例。 25例MPC特点如下:1.55岁以上20例(80％);2.24例(96％)第2原发癌为1980年后发现;3.第2原发癌为肺癌者23例(92％);4.双原发肺癌12例(48％)。上述特点说明80年代老年人中MPC,尤其是肺癌发病率增高。 本文着重对第2原发肺癌的影像学表现和鉴别诊断进行讨论。

Imaging Diagnosis of Primary Bronchogenic Carcinoma Associated with Multiple Primary Carcinoma of Lungs and Other Organs

Out of 527 cases of primary bronchogenic carcinoma(PBC) (1972-1987), confirmed by pathology, there were 25 cases (4.7%) of Multiple primary cacinoma(MPC). Among them, there were 12 cases of dual PBC (DPBC) and 6 cases of PBC associated with digestive system carcinoma. 52 primary carcionmas were found in these 25 patients. Among these 25 cases, there were 2 cases of three primary carcinomas. There were 6 synchronus (4 cases of DPBC) and 19 metachronus cases, among which 14 cases had an interval of over 3 years. The longest intervals were as long as 14 and 25 years. Most second PBC (8 / 12)were found in the upper lobe. 8 cases had identical histologie, and the other four cases had different types.The characteristics of these 25 cases are as follows: (1)20 patients (80%)were over 55 years old; (2) 24 cases (96%) of the second primary carcinoma were discovered after 1980; (3) 23 cases (92%) of the second, primary carcinoma were those of PBC; (4) there were 12 cases (48%) of DPBC. These characteristics suggest that the incidence of MPC, especially of PBC, among the aged patients increased in the eighties.This paper lays emphasis on the discussion of imaging manifestation and differential diagnosis of 23 cases of the second PBC.