肝癌肺部转移的X线表现

The Roentgen Manifestation of Pulmonary Metastasis from the Liver Cancer.

本文分析31例原发性肝癌肺转移。肺部转移以血行多发瘤灶最为常见(29/31例,93.5%),且出现早,发展快.转移的径路属肝静脉型。在X 线上出现可辨别的病灶前,常可见局部肺纹理的模糊和紊乱,可能是肿瘤微栓塞所致,似可视为肺转移的前期征象。小于1cm 的病灶,边界常模糊不清,增大至1cm 左右,边界多较清楚。转移灶间大小差别明显者,常表示先后多次发生的血道播散.少数病例表现为淋巴道转移。肺野内转移征象合并右膈抬高应视为肝癌肺转移的特征性X 线表现.

Thirty one cases of pulmonary metastasisfrom the primary hepatoma were studied.The majority of cases showed hematogenousmetastasis with multiple nodules(93.5%),which developed early and progressedrapidly.The hematogenous route is ofhepatic vein type.Shortly beforerecognizable lesions appeared on chest film.the haziness and irregularity of local lungmarkings could usually be seen,which mightbe caused by the microscopic tumor embolicand be a warning sign of pulmonarymetastasis.Generally.lesions less than 1 cmhad a poorly-defined border,while those greater than 1 cm had a sharp margin.If asignificant difference is found between thesizes of metastatic lesions,repeatedmetastasis through hematogenous routeduring a certain period of time should beconsidered.A few cases appeared as alymphatic metastasis pattern.The finding ofpulmonary metastatic lesions accompanied byan elevated right hemidiaphragm ispathognomonic of pulmonary metastasis fromthe primary liver cancer.