Gaeta M, Caruso R, Barone M, Volta S, Casablanca G, La Spada F
Service of Diagnostic Imaging, Ospedale Piemonte, Messina, Italy.
J Comput Assist Tomogr. 1998 Mar-Apr;22(2):215-9. doi: 10.1097/00004728-199803000-00010.
The purpose of our study was to assess the CT patterns and prognostic value of ground-glass attenuation in nodular bronchioloalveolar carcinoma (BAC).
We retrospectively reviewed CT examinations of 22 patients with 24 nodular BACs who underwent surgery. CT and pathologic findings were analyzed and correlated with postoperative course of disease.
We detected five patterns of ground-glass attenuation associated with nodular BAC: pure ground-glass nodule (n = 1), ground-glass nodule with superimposed lymphangitis (n = 1), nodule with mixed areas of ground-glass attenuation and consolidation (n = 2), ground-glass halo around nodule (halo sign) (n = 3), and nodule associated with a plurisegmental area of ground-glass attenuation (n = 1). Two patients with the halo sign and a third patient with a plurisegmental area of ground-glass attenuation rapidly developed diffuse pulmonary disease by bronchogenic spread and died a few months after surgery.
Our series demonstrates that focal BAC may progress to diffuse pulmonary involvement by bronchogenic spread. The presence of a large area of ground-glass attenuation associated with a nodular BAC might be the CT sign of an aggressive biologic behavior. In these cases there is a high likelihood for diffuse disease to develop from bronchogenic spread.
本研究旨在评估结节型细支气管肺泡癌（BAC）中磨玻璃影的CT表现及其预后价值。
我们回顾性分析了22例接受手术治疗的24个结节型BAC患者的CT检查结果。对CT和病理结果进行分析，并与术后病程进行关联。
我们检测到与结节型BAC相关的五种磨玻璃影模式：纯磨玻璃结节（n = 1）、伴有叠加淋巴管炎的磨玻璃结节（n = 1）、磨玻璃影与实变混合区域的结节（n = 2）、结节周围的磨玻璃晕（晕征）（n = 3）以及与多节段磨玻璃影区域相关的结节（n = 1）。两名有晕征的患者和另一名有多节段磨玻璃影区域的患者通过支气管播散迅速发展为弥漫性肺部疾病，并在术后数月死亡。
我们的系列研究表明，局灶性BAC可能通过支气管播散进展为弥漫性肺部受累。与结节型BAC相关的大面积磨玻璃影可能是侵袭性生物学行为的CT征象。在这些病例中，支气管播散导致弥漫性疾病发生的可能性很高。
