肺小细胞癌的X线诊断

X-ray Diagnosis of Small Cell Lung Carcinoma

本文分析了260例肺小细胞癌临床X线表现,通常分为3种亚型:(1)肺门纵隔型(62％),为最常见的典型表现对称或一侧性肺门纵隔增大及肿块,(2)气道阻塞型(23％),肺门及纵隔变化轻而缺乏肿块,以肺炎或肺不张表现明显。(3)周边肿块型(15％),X线显示肺内结节或肿块,并且肺门纵隔早期转移。本组有10例为特殊表现类似纵隔肿瘤极易误诊,建议为第4亚型即纵隔肿瘤型。另外CT检查在显示支气管继发阻塞性改变方面优于常规X线检查,故对诊断有困难时推荐CT检查是有益的。

X-ray manifestations of 260 cases of small cell lung carcinoma (SCLC) were studied. The usual radiological appearence of SCLC could be divided into threc subtypes: (1) Hilus-mediastinum type (62%), the hilus extends to the mediastinum, which is symmetrically or unilaterally enlarged. (2) Obstructive pneumonia/atelectasis type (23%), the hilar and mediastinal changes are very slight or absent, but the obstructive pneumonia/atelectasis are very obvious. (3) Peripheral mass type (15%) roentgenogram shows a nodule or mass in the lung field with hilar/mediastinal metastasis oftentimes. There is only a symmetrical or unilateral mass of the mediastinum in the other 10 cases,a fact that is easily mistaken for mediastinal tumor. The latter one may be classified as the fpurth subtype. CT scan is superior to conventional radiography in showing secondary lesion of bronchial obstruction. Hence whenever in doubt CT is recommended.