肺癌的肿瘤分期及ct影像学表现课件

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1、肺癌的肿瘤分期及CT影像学表现南方医科大学第一临床医学院T1T1:Atumorlessthanorequalto3cmingreatestdimension,surroundedbylungorvisceralpleura,withoutbronchoscopicevidenceofinvasionmoreproximalthanthelobarbronchus(i.e.,notinthemainbronchus).T1Example1:ThisisanexampleofarightlungT1lesion(inthisc

2、aseanadenocarcinoma).Thetumormeasures2.4cminsizeandiscompletelysurroundedbylung.T1Example2:ThisisanexampleofaT1lesionintheleftlung(thenodulardensityintherightlunganteriorly[bluearrow]istheinferiormarginoftherightclavicularhead).Thetumormeasures1.8cminsizeandiscomp

3、letelysurroundedbylung.Athinlineardensityradiatestothepleuralsurfacefromthelesion-thisisreferredtoasa"pleuraltag"whichisfelttorepresenttumor-inducedthickeningoftheinterlobularsepta.Thereisafocaltriangular-shapedpleural-baseddensityidentifiedattheinsertionofthe"ple

4、uraltag"(blackarrow).Thisfindingisfelttobesecondarytothedesmoplasticreactionincitedbythetumor.Thereisretractionofthevisceralpleuratowardsthelesion,andasmallquantityoffluidcollectswithinthespaceformedbetweenthevisceralandparietalpleuraproducingthefindingidentifiedo

5、ncomputedtomography.Thefindingdoesnotindicatevisceralpleuralinvasion.T2T2:Atumorwithanyofthefollowingfeatures:i)Largerthan3cminlargestdimensionii)Associatedwithatelectasisorpost-obstructivepneumonitisthatextendstothehilarregion,butdoesnotinvolvetheentirelungiii)In

6、vadesthevisceralpleuraT2i)Largerthan3cminlargestdimensionThislargesquamouscellcarcinomameasures5.4cmintransversedimension.Lineardensitiesradiatetothepleuralsurfacefromthelesion.Thereisafocalpleural-baseddensityidentifiedlaterally(bluearrow),buttheunderlyingsubpleu

7、ralfatisnotdisrupted.Thisfindingislikelyduetothedesmoplasticreactionincitedbythetumor.Aspreviouslydiscussed,retractionofthevisceralpleuratowardsthelesionpermitsthedevelopmentofapotentialspacebetweenthevisceralandparietalpleura.Asmallquantityoffluidwithinthespaceca

8、nproduceasoft-tissueopacitybetweenthelesionandthepleuralsurface.T2ii)Associatedwithatelectasisorpost-obstructivepneumonitisthatextendstothehilarregion,b