Sakai F, Maruyama Y, Sone S, Kiyono K, Li F, Honda T, Hainuda M
Department of Radiology, Shinshu University School of Medicine.
Nihon Igaku Hoshasen Gakkai Zasshi. 1996 Nov;56(13):917-23.
We correlated high-resolution CT (HR-CT) images of 30 surgically resected epidermoid carcinomas in peripheral lung fields with pathologic findings. We classified peripheral epidermoid carcinomas into three types based on HR-CT findings. All tumors showed a notch along their margin. Type 1 shows scanty speculations without the convergence of surrounding lung structures. Type 2, which has two subtypes, shows a spiculated border with the convergence of peripheral lung structures. Type 2a has fine irregularities in its border, while type 2b has few fine irregularities. The convergence of peripheral lung structures seen in type 2 carcinoma is caused by the presence of scar tissue within tumors. Speculations corresponded to tumor extension or lymphocytic infiltration, sometimes along pulmonary vessels or interlobular septa, and fine irregularities seen in type 2a corresponded to summation of fibrous thickening of alveolar septa. Nine tumors showed varying-sized cavities, which were caused by the circulatory disturbance and/or central necrosis seen in tumor nests. In conclusion, HR-CT images were well correlated with pathologic findings of the resected specimens; however, some type 2a tumors may mimic adenocarcinoma on HR-CT findings.
我们将30例手术切除的外周肺野表皮样癌的高分辨率CT(HR-CT)图像与病理结果进行了对比。我们根据HR-CT表现将外周表皮样癌分为三种类型。所有肿瘤边缘均有切迹。1型表现为极少的毛刺,周围肺结构无聚拢。2型有两个亚型,表现为有毛刺的边界,周围肺结构聚拢。2a型边界有细微不规则,而2b型几乎没有细微不规则。2型癌中所见的周围肺结构聚拢是由肿瘤内瘢痕组织的存在所致。毛刺对应肿瘤浸润或淋巴细胞浸润,有时沿肺血管或小叶间隔,2a型中所见的细微不规则对应肺泡间隔纤维增厚的总和。9个肿瘤显示大小不一的空洞,这是由肿瘤巢内的循环障碍和/或中央坏死所致。总之,HR-CT图像与切除标本的病理结果密切相关;然而,一些2a型肿瘤在HR-CT表现上可能类似腺癌。