最新0肺癌的肿瘤分期及CT影像学表现课件PPT.ppt

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1、0肺癌的肿瘤分期及CT影像学表现T1T1:Atumorlessthanorequalto3cmingreatestdimension,surroundedbylungorvisceralpleura,withoutbronchoscopicevidenceofinvasionmoreproximalthanthelobarbronchus(i.e.,notinthemainbronchus).T1Example1:ThisisanexampleofarightlungT1lesion(inthiscaseanadenocarcinoma).Th

2、etumormeasures2.4cminsizeandiscompletelysurroundedbylung.T2ii)Associatedwithatelectasisorpost-obstructivepneumonitisthatextendstothehilarregion,butdoesnotinvolvetheentirelungInthispatientwithsquamouscellcarcinoma,thereisanendobronchiallesionattheoriginoftheleftupperlobebronc

3、hus(bluearrow).Thereisleftupperlobecollapsewhichhascausedtheleftmainstembronchustoassumeamorehorizontalcourse.Theatelectasisextendstothehilarregion,butdoesnotinvolvetheentireleftlung.T2iii)InvadesthevisceralpleuraExample1:Thispatientpresentedwitha4.5cmcarcinosarcomaintherigh

4、tupperlobe.Thelesionabuttedthechestwallalongitssuperiormargin(bluearrows).Atresection,thetumorinvadedthevisceralpleura,buttheparietalpleurahadnoevidenceofinvolvement.T2iii)InvadesthevisceralpleuraExample2:Thisisaninterestingexampleofvisceralpleuralinvasion.Inthiscaseofadenoc

5、arcinomatherearethinstandsofdensitywhichareseenradiatingfromthelesiontothepleuralsurfacewherethereisafocalplaque-likesofttissuemass(yellowarrows).Onhistopathologicanalysistherewasvisceralpleuralextensionoftheprimarylesion(makingthelesionT2),butthepleuralsofttissuemassprovedt

6、obefibroustissueandscar.Thus,theprimarylesiondoesnotnecessarilyneedtobeindirectcontactwiththepleuratohaveinvasion.T3T3:Atumorofanysizethatdirectlyinvadesanyofthefollowing:thechestwall(includingsuperiorsulcustumors),diaphragm,mediastinalpleura,parietalpericardium;ortumorinthe

7、mainbronchuslessthan2cmdistaltothecarina(butwithoutinvolvementofthecarina);ortumorassociatedwithatelectasisorobstructivepneumonitisoftheentirelung.T3Example1:T3lesion-chestwallinvasion.Thispatientpresentedwithalonghistoryofshoulderandneckpain.AnabnormalitywasdetectedonCXRand

8、aCTscanconfirmedthepresenceofasuperiorsulcustumor(anadenocarcinoma)associat