Johkoh T, Ikezoe J, Tomiyama N, Nagareda T, Kohno N, Takeuchi N, Yamagami H, Kido S, Takashima S, Arisawa J
Department of Radiology, Osaka University Medical School, Japan.
AJR Am J Roentgenol. 1992 Jun;158(6):1217-22. doi: 10.2214/ajr.158.6.1590110.
The purpose of this study was to analyze the CT findings in lymphangitic carcinomatosis and to determine how the abnormalities seen on CT correlated with histologic findings and the results of pulmonary function tests. Accordingly, we reviewed CT findings in 20 proved cases and correlated them with histologic findings and with results of pulmonary function tests (available in 11). Special attention was given to the extent and degree of thickening of the peripheral and/or axial interstitium as seen on CT. In 15 of 20 patients, CT scans showed marked thickening of axial interstitium and subtle or no thickening of peripheral interstitium (four diffuse and 11 localized). In three cases, CT showed marked thickening of both axial and peripheral interstitium (two diffuse and one localized). In two cases, CT showed marked thickening of peripheral interstitium and subtle or no thickening of axial interstitium (one diffuse and one localized). These CT findings correlated with the pathologic findings. Marked impairment of vital capacity and alveolar-arterial oxygen gradient was observed in three patients (one with diffuse and peripheral interstitial thickening and two with diffuse and both peripheral and axial interstitial thickening). We conclude that CT findings in patients with lymphangitic carcinomatosis are variable and that marked impairment of pulmonary function occurs in patients with diffuse and peripheral interstitial thickening. Marked impairment of pulmonary function can be predicted from CT findings.
本研究的目的是分析淋巴管癌病的CT表现，并确定CT上所见异常与组织学表现及肺功能测试结果之间的相关性。因此，我们回顾了20例经证实病例的CT表现，并将其与组织学表现及肺功能测试结果（11例可获得）进行了相关性分析。特别关注CT上所见外周和/或轴位间质增厚的范围和程度。20例患者中有15例CT扫描显示轴位间质明显增厚，外周间质轻微增厚或无增厚（4例弥漫性和11例局限性）。3例患者CT显示轴位和外周间质均明显增厚（2例弥漫性和1例局限性）。2例患者CT显示外周间质明显增厚，轴位间质轻微增厚或无增厚（1例弥漫性和1例局限性）。这些CT表现与病理结果相关。3例患者（1例伴有弥漫性外周间质增厚，2例伴有弥漫性外周和轴位间质增厚）观察到肺活量和肺泡-动脉氧梯度明显受损。我们得出结论，淋巴管癌病患者的CT表现各不相同，弥漫性外周间质增厚的患者会出现明显的肺功能损害。肺功能的明显损害可根据CT表现预测。
