早期周围型肺癌X线、CT表现及其病理基础

目的:探讨早期周围型肺癌在X线、CT上的影像表现和病理形成基础。方法:搜集病史完整、有X线和CT资料,经穿刺活检、手术、病理证实的17例早期周围型肺癌(首次检查时,直径≤20mm)进行回顾分析,结合文献总结其影像学特征。结果:早期周围型肺癌以小结节状(14例)形式出现多见,形态上表现为圆形或类圆形,密度均匀略低。少数病灶呈空洞型(2例)或斑片样(1例)改变,密度浅淡,状如肺炎。分叶、毛刺、胸膜凹陷征等征象随病变进展而典型,而毛刺、胸膜凹陷征常见于腺癌,鳞癌的分叶、空洞征较多见,空泡征以肺泡癌多见。结论:早期周围型肺癌影像特征少,容易误诊和漏诊,需平片与CT结合,影像诊断与临床结合,加强随访,当病灶出现分叶、毛刺、胸膜凹陷等征象时,应高度怀疑早期肺癌。

The X-ray and CT performance of the early peripheral lung cancer and its pathology foundation

Objective:To explore the X-ray and CT performance of the early peripheral lung cancer and its pathology foundation.Methods: 17 cases of early peripheral lung cancer(diameter≤20mm on first scan),with complete clinical informations,X-ray and the CT materialafter pathology confirms of puncture biopsy,were retrospectively analysed.Results: The form of the early peripheral lung cancer(14cases) appeared more tubercle type,in the shape of performance appeared round or oval and the density were slightly low.Few lesions appeared cavitation sign(2 cases) and patchy shadows(1case),with superficial density and like pneumonia.Lobulation sign,burr sign,pleuralindentation sign and so on were typical with advances in disease in which burr sign and pleural indentation sign were common in adenocarcinoma,lobulation sign and cavitation sign in squamous cell carcinoma,vacuole sign in alveolar carcinoma.Conclusion: The early peripheral lung cancer imaging features are few,and is easily to misdiagnose and missed diagnosis.When appears of lobulation sign,burr sign,pleural indentation sign and so on,there should be united the image diagnosis and the clinical,the X-ray and the CT in diagnosis,and makes a follow-up visit and should highly suspect the early lung cancer.