原发性肺癌不典型CT表现的研究

The untypical CT expression of primary cancer of lung

收集１５４例经胸部ＣＴ检查、手术病理检查、抽胸水作细胞学检查、纤维支气管镜检查及取活检等方法确诊为肺癌的病例，着重研究这些肺癌的ＣＴ表现及相应的病理基础，并且对这些肺癌的不同表现进行分类。结果发现，本组病例的ＣＴ表现有：①大空洞及周围片状阴影３例；②肺叶肺段实变、肺不张合并胸水６０例；③肺脓肿样变１６例；④肺门肿块合并胸水５９例；⑤肺结核合并肺癌１２例；⑥肺空洞合并胸椎破坏１例；⑦囊肿样变合并胸水３例。表明原发性肺癌不典型ＣＴ表现与肺癌的类型有关；与肺癌本身的生长方式有关；与合并结核病有关；与肺癌的恶性程度及胸膜胸壁转移有关。原发性肺癌不典型ＣＴ表现给ＣＴ诊断带来一定困难，但如果对肺癌的病理基础及临床表现很了解，同时又能全面观察和详细分析ＣＴ表现而且能以肺癌的病理变化为基础，全面综合分析。

In this study, CT chest examination, post-operative pathological examination, aspirating hydrothorax, cytological examination, fiberbronchoscope and biopsy were used to confirm 154 patients with lung of cancer. The CT expression and its correspondend pathological base were paied attention to, and these different expressions were categorized. Results showed that the CT expressions as: ① 3 big cavity and peripheral pleated shadow; ②60 parenchymatous degeneration of pulmonary segments in lobes of lung, atelectasis with hydrothorax; ③16 pulmonary abscess degeneration; ④59 hilar tumor with hydrothorax; ⑤12 tuberculosis of lung with cancer of lung; ⑥1 pulmonary cavity with thoracic vertebrae destruction; ⑦ 3 cystic degeneration with hydrothorax. It indicated that the untypical CT expressions of primary cancer of lung correlates with the types of lung cancer; with the grown-up styles of lung cancer themselves; with the combined tuberculosis; with the malignancy degree of lung cancer and pleura chest wall transfer, as well. The untypical CT expressions of primary cancer of lung had some difficulties in CT diagnose, but further diagnostic level can be improved if overall analysis that based on the pathological changes can be done by mastering the pathological base and clinical manifestation.