摘要
目的分析青年人群肺腺癌CT影像学表现特点及病理。方法回顾性分析2012年1月～2013年6月经临床病理确诊为原发性肺腺癌57例患者的临床、影像学资料及病理结果。结果从出现症状到明确诊断平均时间为（3.6±0.4）个月。16例（28%）误诊或延误诊疗。57例肺腺癌中,表现为中央型4例,周围型52例,弥漫型1例;多原发肺癌2例。肺内原发灶表现为肿块和结节的46例,其中磨玻璃结节2例,其余为实性。出现分叶征39例,毛刺征29例,胸膜凹陷征27例。可判断病理分化程度的51例,其中原位腺癌1例,微浸润腺癌1例,浸润型腺癌中高分化腺癌4例,中高分化2例,中分化14例,中低分化9例,低分化20例。确诊时已发生转移44例,胸部转移共38例,胸腔积液14例。结论青年肺腺癌以周围型为主,CT主要表现为肿块、结节,分化程度差,多数病例确诊时已发生转移,误诊及延误诊疗多见。
Objective To describe CT features and tumor cell differentiation in pathology in adenocarcinoma of lung in young patients. Methods The clinical data and CT findings of lung adenocarcinoma proved pathologically in 57 young patients were reviewed. Results The average duration from symptom onset to diagnosis was（3.6±0.4） months. 16 cases were misdiagnosed. There were 4 patients with central bronchogenic carcinoma, 52 with peripheral bronchogenic carcinoma, 1 with diffuse bronchial carcinoma（DBC） and 2 with multiple primary bronchial carcinomas（MPBC）, 46 cases presented as masses and nodules and 39 with lobulation, 29 with speculation and 27 with pleural indentation. There were 51 patients with discernible degree of cancer differentiation, 1 case with AIS, 1 with minimally invasive adenocarcinoma, among invasive adenocarcinoma, 4 with high differentiation, 2 with high-moderate differentiation, 14 with moderate differentiation, 9 with low-moderate differentiation and 20 with low differentiation. Most of the cases were advanced stage when diagnosed, 44 presented with metastasis, 38 patients with chest metastasis, pleural effusion occurred in 14 patients. Conclusion Peripheral mass and nodule are the predominant CT features of lung adenocarcinoma in young patients. Poor-differentiated tumor with metastasis is common when diagnosed.
出处
《中国医疗设备》
2014年第5期157-160,共4页
China Medical Devices
