不典型外围型肺癌的CT误诊分析

Analysis of the misdiagnosis of atypical peripheral lung cancer

目的 :探讨不典型外围型肺癌的CT诊断。方法 :对 7例不典型外围型肺癌进行回顾性分析 ,全部患者均摄有胸部正侧位片 ,并行常规CT平扫及强化扫描 ,病变区行 3.0mm薄扫 ,并对前后CT片进行比较。结果 :7例病变中 ,位于左肺上叶 2例 ,下叶 1例 ,右肺下叶 3例 ,中叶 1例。术后病理为中分化腺癌 4例 ,鳞状细胞癌 2例 ,细支气管肺泡癌 1例。结论 :X线胸片、CT平扫及强化扫描对不典型外围型肺癌较难作出正确诊断。缺乏影像特征性病变的患者应短期治疗后复查 ,重点观察病变有无变化。

Objective:To summarize the manifestation and diagnosis of atypical peripheral lung cancer on CT.Methods:To perform the retrospective analysis in 7 cases of atypical peripheral lung cancer with CT images.All the cases had taken AP and lateral chest films.Then,they had the CT plain scanning and the enhanced scanning.In the area of anomaly,the thin slice of 3mm was taken.The former and the latter CT images were compared.Results:Among the 7 cases,2 focuses were at the upper lobe of left lung,one at the lower lobe of left lung.Three cases were at the lower lebe of right lung and one case was at the middle lobe of right lung.The pathologic results were as following:4 cases of middle-differentiated adenocarcinoma,2 cases of squamocellular cancinoma and 1 case of bronchiole-alveolar carcinoma.Conclusion:X-ray chest films,CT plain scanning and enhanced scanning are difficult to diagnose atypical peripheral lung cancer.The patients who are lack of characteristic changes in imaging shulld take the callback CT scanning after a short term of treatment,because it is important for them to observe the changes during this period.If the patient could not mend nicely,the cellular examination of lung or the pneumonectomy should be performed as quickly as possible.