北京协和医院：《放射诊断学》课程教学资源（PPT课件）肺癌与肺结核影像学诊断

肺癌与肺结核 的影像学诊断

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

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

Squamous cell Ca ◆30-40%，generally central(70% hilar or perihilar in subsegmental or larger bronchi) .strong association with cigarette smoking about 15%bronchogenic carcinomas are cavitary,and of these,nearly 60%are squamous cell lesions,wall typically thick and nodular

Squamous cell Ca  30-40%，generally central (70% hilar or perihilar in subsegmental or larger bronchi)  strong association with cigarette smoking  about 15% bronchogenic carcinomas are cavitary, and of these, nearly 60% are squamous cell lesions, wall typically thick and nodular

.intralumenal growth pattern- often resulting in distal atelectasis or post-obstructive pneumonitis (a non-infectious process). .the lowest frequency of distant metastases,spreads to involve local nodes by direct extension .the most favorable prognosis Hypertrophic osteoarthropathy

intralumenal growth pattern￾often resulting in distal atelectasis or post-obstructive pneumonitis (a non-infectious process). the lowest frequency of distant metastases, spreads to involve local nodes by direct extension the most favorable prognosis Hypertrophic osteoarthropathy

adenocarcinoma ◆ as common as squamous cell carcinoma (30-40%). generally peripheral (75%) uncommonly cavitate commonly metastasizes early to lymph nodes,the pleura,adrenal glands,CNS,and bone

adenocarcinoma  as common as squamous cell carcinoma (30-40%).  generally peripheral (75%)  uncommonly cavitate  commonly metastasizes early to lymph nodes, the pleura, adrenal glands, CNS, and bone

Small cell Ca .15-20%of primary lung malignancies the strongest association with cigarette smoking the most likely to produce ectopic hormones-most commonly resulting in Cushings syndrome (ACTH)or syndrome of inappropriate antidiuretic hormone (SIADH)

Small cell Ca  15-20% of primary lung malignancies  the strongest association with cigarette smoking  the most likely to produce ectopic hormones- most commonly resulting in Cushings syndrome (ACTH) or syndrome of inappropriate antidiuretic hormone (SIADH)

◆ 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

 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

Large Cell Ca ◆only5-10% strongly associated with cigarette smoking typically peripheral and generally large (over 4 to 6 cm),with rapid growth,early metastases,and a poor prognosis

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

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

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

影像诊断 ◆目的：明确诊断，TNM分期 ◆手段：X线平片、CT、MRI、PET等

影像诊断  目的：明确诊断，TNM分期  手段：X线平片、CT、MRI、PET等