以云絮状影为首发表现的16例肺腺癌分析

Analysis of 16 cases of lung adenocarcinoma manifested as cloudy opacity

目的分析早期呈云絮影的肺腺癌的CT表现、伴随特征及演变过程,以期提高对肺腺癌早期表现及病变过程的认识。方法回顾性分析2005-2008年初诊时表现为肺云絮影、经手术病理证实为肺腺癌的16例病例,总结其具有特征性的CT表现、伴随特征及演变过程。结果16例病例中,病灶形态表现为类圆形的8例,楔形3例,不规则形5例;2例拟诊为肺癌即进行手术治疗,余14例经过随访,9例发展成为实性结节,5例呈现混杂密度结节。所有云絮影中,直径>20mm的4例,<20mm的12例。3例原发病灶周围可见少量肺气肿,2例病灶周围可见条索样瘢痕,5例可见临近胸膜凹陷,2例周围可见晕征,4例无伴发征象。结论局限性肺云絮影及其伴随征象在早期肺癌具有一定的诊断价值,结合相应的临床表现可缩小拟诊范围。

Objective To investigate the CT features,the assistant phenomenon and the progress of lung adenocarcinoma manifested as cloudy opacity for improving the possibility of early diagnosis. Methods Sixteen cases of lung adenocarcinoma with cloudy opacity firstly diagnosed by pathology, were retrospectively analyzed. CT features, assistant phenomenon and progress were summarized. Results Of 16 cases, 8 cases manifested round, 3 cases were of wedge shape, and 5 cases were irregular. Two cases were operated after diagnosis. The other 14 cases were followed up. Of 14 cases ,9 cases developed the solid noduses, and 5 cases developed the mixed types of no- duses. Of 16 cases ,4 cases showed the diameter larger than 20 mm, and the others were smaller than 20 mm. Three cases had focal em- physema around focus ,2 cases had fibrosis ,5 cases had pleural indentation sign,2 cases had halo sign, and 4 cases showed no assistant phenomenon. Conclusion Focal cloudy opacity and assistant phenomenon could help to diagnose the early lung adenocarcinoma, and can lessen diagnostic extent combined with clinical phenomenon.