Pearlberg J L, Sandler M A, Beute G H, Madrazo B L
Radiology. 1985 Oct;157(1):187-90. doi: 10.1148/radiology.157.1.4034964.
We reviewed medical records and conventional chest radiographs that showed a solitary T1N0M0 nodule in 23 patients who had non-oat-cell bronchogenic carcinoma. No patient had evidence of metastases, either on the chest radiograph or clinically. All patients underwent computed tomography (CT) examination of the thorax, including the adrenal glands. Only one patient (4%) had mediastinal lymph nodes greater than 1 cm in diameter accessible to mediastinotomy; anterior mediastinotomy confirmed metastatic spread in this patient, which precluded curative resection. Three patients each had a mildly enlarged (2 cm or less) adrenal gland; however, follow-up study suggested that metastasis was not the cause of adrenal enlargement in these patients. This study reinforces concern over whether CT is warranted in the preoperative assessment of T1N0M0 bronchogenic carcinoma.
我们回顾了23例非燕麦细胞型支气管源性癌患者的病历及常规胸部X线片，这些检查显示有孤立性T1N0M0结节。无论是胸部X线片还是临床检查，均无患者有转移证据。所有患者均接受了胸部计算机断层扫描（CT）检查，包括肾上腺。只有1例患者（4%）有直径大于1 cm的纵隔淋巴结，可通过纵隔切开术触及；前纵隔切开术证实该患者有转移扩散，这排除了根治性切除的可能。3例患者各有一个轻度增大（2 cm或更小）的肾上腺；然而，随访研究表明，转移并非这些患者肾上腺增大的原因。这项研究强化了对于在T1N0M0支气管源性癌的术前评估中CT检查是否必要的担忧。
