外围型肺癌血管集束征的病理基础

探讨外围型非小细胞肺癌（PNSCLC）血管集束征的病理基础，收集经病理实的46例PNSCLC的新鲜肺切除标本，灌注固定后做CT病理对照前瞻性研究，重点观察瘤周血管的病理变化，结果：46例PNSCLC大体标本横切面肉眼观，在瘤体边缘部分可见血管及支气管伸入瘤体，或被包埋在瘤体之中，而形成一凹陷，镜下观，在瘤体边缘可见血管或被癌组织浸润包绕，或被牵拉伸入瘤体内，在小叶间隔内血管旁常可见到程度不同的纤维组织增生，在被牵拉的肺血管旁，还可见到小支气管也被肿瘤组织牵拉或包绕的现象，结论：血集束征的病理基础是肿瘤组织向血管支气管鞘或小叶间隔浸润生长，瘤体内纤维组织增生或瘢痕形成牵拉邻近血管向瘤体集中所致。

The Pathologic Basis of Convergence of Vessels in Peripheral Lung Cancer

To explore the pathologic basis of convergence of peripheral vessels in nonsmall cell lung cancer(NSCLC).Fortysix fresh surgical specimens of peripheral nonsmall cell lung cancer(PNSCLC) proved by pathology were collected and made into histological sections after perfusion fixation for prospective study of CTpathological correlation, emphasizing the pathological changes in the peripheral and surrounding tissue of the tumor.Results:It was found in all gross specimens of 46 PNSCLC that blood vessels and bronchial branches in the periphery of the tumor extended into or were embedded in the tumor mass, forming a depression at their entrance.Under the microscope,the vessels in the periphery of the tumor were found to be surrounded by infiltration of cancerous tissue or dragged into the tumor mass;various degrees of hyperplasia of perivascular fibrous tissue were freguently seen in the interlobular septa.Along with the dragged blood vessels,small bronchi were seen dragged or surrounded by cancerous tissue as well.Conclusions:The pathologic basis of the convergence of peripheral vessels might be due to infiltration of cancerous tissue toward vasculobronchial sheath or interlobular septa followed by fibrosis and cicatrization in the tumor that pull the neighboring vessels to converge toward the tumor mass.