文档介绍：肺癌与肺结核 的影像学诊断
肺癌分类
♦ Lung cancer, bronchogenic carcinoma
♦病理分型：鳞、小、腺、大
♦临床分型：中央型、周围型、纵隔 型
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Squamous cell Ca
♦ oduce ectopic hormones- most commonly resulting in Cushings syndrome (ACTH) or syndrome of inappropriate antidiuretic hormone (SIADH)
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♦ generally central (85-90% within a lobar or mainstem bronchi) and has a tendency to invade longitudinally along the bronchial wall, in a submucosal and intramural fashion
♦ Internal necrosis is common, but cavitation is extremely rare
♦ the worst prognosis, despite typically good response to initial chemotherapy
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Large Cell Ca
♦ only 5-10%
♦ strongly associated with cigarette smoking
♦ typically peripheral and generally large (over 4 to 6 cm), with rapid growth, early metastases, and a poor prognosis
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Pancoast tumor
♦ apical density (superior pulmonary sulcus)
♦ destruction or adjacent rib or vertebra
♦ Horner's syndrome
♦ pain in arm
♦ usually bronchogenic Ca (squamous type)
♦ also: mets, malignant neurogenic tumor
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影像诊断
♦目的：明确诊断，TNM分期
♦手段：X线平片、CT、MRI、PET等
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Tl: A tumor less than or equal to 3 cm in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than the lobar bronchus (ie, not in the main bronchus).
TUMOR
ii) Associated with atelectasis or post-obstructive pneumonitis that extends to the hilar region, but does not involve the entire lung
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iii) Invades the visceral pleura
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T4: A tumor of any size that invades any of the following: mediastinum, heart, great vessels, trachea, esophagus, vertebral body, carina; or any tumor with a malignant pleural or pericardial effusion; or with satellite tumor nodules within the ipsilateral primary-tumor lobe of the lung.
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Regional Lymph Node Status (N)
Nl: Ipsilateral peribronchial or hilar nodal metastases; or intrapulmonary nodes involved by direct extension of the primary tumor. All N1 nodes lie distal to the mediastinal pleural reflection.
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N3: Contralateral mediastinal or