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[转移性肺肿瘤的CT:形态学、高分辨率CT与组织学相关性]

[CT of metastatic pulmonary tumor: morphology, HRCT and histological correlation].

作者信息

Nakagawa T

机构信息

Department of Radiology, University of Occupational and Environmental Health.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1996 Dec;56(14):1032-8.

PMID:9014464
Abstract

The purpose of this study was to evaluate the CT characteristics of metastatic pulmonary tumor. The study included 163 cases. Analysis of the distribution of 1265 metastatic nodules observed the conventional and helical CT with 10 mm slice thickness showed that they were distributed mainly below the carina and external peripheral lung field. The relationship between the characteristics of the margins of the metastatic nodules and primary tumors was evaluated in 280 nodules with high-resolution CT(HRCT). The margins were smooth in 88% of thyroid cancers, 85% of hepatocellular carcinomas and 75% of renal cell carcinomas, and irregular in 75% of pharyngolaryngeal cancers, 62% of colon cancers and 58% of breast cancers. HRCT findings were correlated with histology in 23 surgically resected metastatic nodules. The well-defined smooth margin on HRCT histologically corresponded to the expanding type, while the irregular margin corresponded predominantly to the alveolar space-filling type. Among other CT findings calcification was seen in colon cancer and osteosarcoma, and cavitation in pharyngolaryngeal cancer, colon cancer angiosarcoma, pancreatic cancer and endometrial uterine cancer. The author concludes that CT is useful for observing the morphologic features of metastatic pulmonary nodules which seem to reflect the underlying pathologic characteristics and thus contributes to the diagnosis.

摘要

本研究的目的是评估转移性肺肿瘤的CT特征。该研究纳入了163例病例。对1265个转移结节的分布进行分析,这些结节通过层厚10mm的常规CT和螺旋CT观察,结果显示它们主要分布在隆突下方和肺野外周。对280个通过高分辨率CT(HRCT)观察的转移结节,评估了转移结节边缘特征与原发肿瘤之间的关系。甲状腺癌转移结节边缘光滑的占88%,肝细胞癌为85%,肾细胞癌为75%;而咽喉癌转移结节边缘不规则的占75%,结肠癌为62%,乳腺癌为58%。对23个手术切除的转移结节的HRCT表现与组织学结果进行了对比。HRCT上边界清晰光滑的边缘在组织学上对应膨胀型,而不规则边缘主要对应肺泡腔填充型。在其他CT表现中,结肠癌和骨肉瘤可见钙化,咽喉癌、结肠癌、血管肉瘤、胰腺癌和子宫内膜癌可见空洞形成。作者得出结论,CT有助于观察转移性肺结节的形态特征,这些特征似乎反映了潜在的病理特征,从而有助于诊断。

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