肺癌的肿瘤分期及CT影像学表现.ppt

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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(inthiscaseanadenocarcinoma).Thetumormeasu

2、res2.4cminsizeandiscompletelysurroundedbylung.T1Example2:ThisisanexampleofaT1lesionintheleftlung(thenodulardensityintherightlunganteriorly[bluearrow]istheinferiormarginoftherightclavicularhead).Thetumormeasures1.8cminsizeandiscompletelysurroundedbylung.Athinlineardensityradiatestothepleuralsurface

3、fromthelesion-thisisreferredtoasa"pleuraltag"whichisfelttorepresenttumor-inducedthickeningoftheinterlobularsepta.Thereisafocaltriangular-shapedpleural-baseddensityidentifiedattheinsertionofthe"pleuraltag"(blackarrow).Thisfindingisfelttobesecondarytothedesmoplasticreactionincitedbythetumor.Thereisr

4、etractionofthevisceralpleuratowardsthelesion,andasmallquantityoffluidcollectswithinthespaceformedbetweenthevisceralandparietalpleuraproducingthefindingidentifiedoncomputedtomography.Thefindingdoesnotindicatevisceralpleuralinvasion.T2T2:Atumorwithanyofthefollowingfeatures:i)Largerthan3cminlargestdi

5、mensionii)Associatedwithatelectasisorpost-obstructivepneumonitisthatextendstothehilarregion,butdoesnotinvolvetheentirelungiii)InvadesthevisceralpleuraT2i)Largerthan3cminlargestdimensionThislargesquamouscellcarcinomameasures5.4cmintransversedimension.Lineardensitiesradiatetothepleuralsurfacefromthe

6、lesion.Thereisafocalpleural-baseddensityidentifiedlaterally(bluearrow),buttheunderlyingsubpleuralfatisnotdisrupted.Thisfindingislikelyduetothedesmoplasticreactionincitedbythetumor.Aspreviouslydiscussed,retractionofthevisceralpleuratowardsthelesionpermitsthedevelopmentofapotentialspacebetweenthevis

7、ceralandparietalpleura.Asmallquantityoffluidwithinthespacecanproduceasoft-tissueopacitybetweenthelesionandthepleuralsurface.T2ii)Associatedwithatelectasisorpost-obstructivepneumonitisthatextendstothehilarregion,b