空洞型肺癌的CT表现与病理对照分析

目的研究空洞型肺癌的CT表现特点，并与病理结果对照，提高该病的诊断正确率。方法回顾性分析18例经手术或者穿刺活检病理证实的空洞型肺癌的CT表现，其中男16例，女2例，年龄39。79岁，平均年龄为62岁，全部病例均行CT平扫，其中14例同时行增强扫描。结果18例中病灶位于肺上叶者13例，下叶者5例；全部病例均为单发空洞，病灶平均最大径5．3cm，4．cm以上者占61％（11／18）；83％（15／18）外形呈分叶状，61％（11/18）例边缘毛糙，见毛刺征象；89％（16／18）为厚壁空洞，壁厚薄不均，其中22％（4／18）可见壁结节；所有空洞周围均未见卫星病灶；18例中病理结果为腺癌者67％（12／18），鳞癌者16％（3／18），17％（3／18）为非小细胞肺癌而无法确定是鳞癌、腺癌或者大细胞癌。结论空洞型肺癌的CT表现有一定的特征性，CT是诊断空洞型肺癌的最佳检查方法；而空洞型肺癌的组织病理学类型中腺癌的比例有上升趋势。

Comparative analysis of CT features of lung cancer cavity with pathological findings

Objective To study the CT features Of primary lung cancer cavity and compare with the pathological findings in order to improve the diagnostic accuracy. Methods CT features of primary lung cancer cavities in 18 cases proven by operation or biopsy pathology were analyzed retrospectively. 16 men and 2 women, with the age ranged from 39-79 years and the mean age of 62 years, were performed with plain CT, while contrast CT scans were done in 14 cases. Results Solitary pulmonary cavity was found in all 18 cases. The lesions were located in the upper lung lobe in 13 cases and lower lobe in 5 cases. The maximum cavity size was 53 mm in diameter and 61% （11/18） lesions were more than 6cm. Most of cavities （83%, 15/18） were slightly lobulated. The cavity showed irregular thick wall in 89% （16/18） cases and obvious wall nodules in 22% （4/18） cases. Not satellite focus was found around all cavities. Among 18 cases, 67% （12/18） were adenocarcinoma and 16% were squamous cell carcinoma. Conclusions There are some characteristic CT findings of lung cancer cavities. CT may be the best examination method for lung cancer cavity. The adenocarcinoma has an escalation trend in the pathology of cavity lung cancer.