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1、肺癌與肺結(jié)核 的影像學(xué)診斷肺癌分類(lèi)Lungcancer,bronchogeniccarcinoma病理分型：鱗、小、腺、大臨床分型：中央型、周?chē)?、縱隔型SquamouscellCa30-40%，generallycentral(70%hilarorperihilarinsubsegmentalorlargerbronchi)strongassociationwithcigarettesmokingabout15%bronchogeniccarcinomasarecavitary,andofthese,nearly60%aresq
2、uamouscelllesions,walltypicallythickandnodularintralumenalgrowthpattern-oftenresultingindistalatelectasisorpost-obstructivepneumonitis(anon-infectiousprocess).thelowestfrequencyofdistantmetastases,spreadstoinvolvelocalnodesbydirectextensionthemostfavorableprognosisHyp
3、ertrophicosteoarthropathyadenocarcinomaascommonassquamouscellcarcinoma(30-40%).generallyperipheral(75%)uncommonlycavitatecommonlymetastasizesearlytolymphnodes,thepleura,adrenalglands,CNS,andbone.SmallcellCa15-20%ofprimarylungmalignanciesthestrongestassociationwithciga
4、rettesmokingthemostlikelytoproduceectopichormones-mostcommonlyresultinginCushingssyndrome(ACTH)orsyndromeofinappropriateantidiuretichormone(SIADH)generallycentral(85-90%withinalobarormainstembronchi)andhasatendencytoinvadelongitudinallyalongthebronchialwall,inasubmuco
5、salandintramuralfashionInternalnecrosisiscommon,butcavitationisextremelyraretheworstprognosis,despitetypicallygoodresponsetoinitialchemotherapyLargeCellCaonly5-10%stronglyassociatedwithcigarettesmokingtypicallyperipheralandgenerallylarge(over4to6cm),withrapidgrowth,ea
6、rlymetastases,andapoorprognosisPancoasttumorapicaldensity(superiorpulmonarysulcus)destructionoradjacentriborvertebraHorner'ssyndromepaininarmusuallybronchogenicCa(squamoustype)also:mets,malignantneurogenictumor影像診斷目的：明確診斷，TNM分期手段：X線平片、CT、MRI、PET等T1:Atumorlessthanorequ
7、alto3cmingreatestdimension,surroundedbylungorvisceralpleura,withoutbronchoscopicevidenceofinvasionmoreproximalthanthelobarbronchus(i.e.,notinthemainbronchus).TUMORT2:Atumorwithanyofthefollowingfeatures:i)Largerthan3cminlargestdimensionii)Associatedwithatelectasisorpos
8、t-obstructivepneumonitisthatextendstothehilarregion,butdoesnotinvolvetheentirelungiii)InvadesthevisceralpleuraT3:Atumorofany
