Chen J T, Dahmash N S, Ravin C E, Heaston D K, Putman C E, Seigler H F, Reed J C
AJR Am J Roentgenol. 1981 Aug;137(2):293-8. doi: 10.2214/ajr.137.2.293.
Early detection of metastatic melanoma has become more important as newer and more effective therapeutic regimens are used. Between 1970 and 1980, 1,600 patients were treated at one institution for malignant melanoma. Of these, 260 (16.3%) developed thoracic metastasis. Satisfactory chest radiographs were available for analysis in 130 of 260 patients. The patterns of the intrathoracic metastasis include multiple pulmonary nodules (52 patients), solitary nodule (26), miliary pattern (two), mediastinal and/or hilar adenopathy (nine), pleural effusion (three), lytic bony lesions (one), extra-pleural mass (one), and combined lesions (36). Both the staging of melanoma and the radiographic pattern of thoracic metastasis seemed to prognosticate the survival rate of these patients. Miliary metastasis and bone destruction implied a grave prognosis. Patients with a solitary lung nodule had the best survival experience. Immunotherapy, chemotherapy, and surgery of selected distal metastases significantly improved the survival of most of these patients.
随着更新、更有效的治疗方案的应用，转移性黑色素瘤的早期检测变得愈发重要。1970年至1980年间，一家机构对1600例恶性黑色素瘤患者进行了治疗。其中，260例（16.3%）发生了胸内转移。260例患者中有130例可获得满意的胸部X线片用于分析。胸内转移的模式包括多发肺结节（52例）、孤立结节（26例）、粟粒样模式（2例）、纵隔和/或肺门淋巴结肿大（9例）、胸腔积液（3例）、溶骨性骨病变（1例）、胸膜外肿块（1例）以及合并病变（36例）。黑色素瘤的分期和胸内转移的影像学模式似乎都能预测这些患者的生存率。粟粒样转移和骨破坏预示着预后不良。孤立性肺结节患者的生存情况最佳。对部分远处转移患者进行免疫治疗、化疗和手术显著提高了这些患者中大多数人的生存率。
