Ct Features of the Small-Cell Bronchogenic Carcinoma

小細胞肺癌的電腦斷層表徵

沈宏儒(Hung-Ju Shen) ； 藍功堯(Gong-Yau Lan) ； 許居誠(Giu-Cheng Hsu) ； 周定遠(Ting-Ywan Chou)

《中華放射線醫學雜誌》 20卷3期 (1995/09) Pp. 195-203

摘要

小細胞肺癌在臨床上的表現有相當典型的特徵，且生長快速。電腦斷層的表現大部份以中央型病灶轉移至肺門或縱隔腔爲常見，甚至只見有縱隔腔淋巴結腫大而無肺部病灶，但其它少見的型態也會發生。電腦斷層已在很多文獻中證實對於肺癌及其分期能提供很好的評估。我們統計自1987至1993年73位治療前診斷有小細胞肺癌的電腦斷層表徵。而依據美國胸腔協會建議的方法，評估縱隔腔淋巴結的分佈情況；根據腫瘤的位置及淋巴結的分佈情形將其分成四類。
淋巴結最好發的位置是右側下支氣管旁及右側肺門各有39位(53%)。最常見的型態是中央型病灶併有縱隔腔或肺門淋巴結佔有79.4%；第二爲週邊型病灶併有縱隔腔或肺門淋巴結佔有13.7%；第三爲單一肺部結節且無縱隔腔及肺門淋巴結佔有4.1%；最少爲浸潤型病灶有二例佔2.7%。此外，我們也評估其它一些相關表徵發生的頻率，如肋膜積水、氣管支氣管或主要的血管被推移、腎臟轉移、肝臟轉移、肺擴張不全、胸壁侵犯、助骨破壞及肺尖結疤纖維化等。

關鍵字

肺腫瘤，電腦斷層攝影 ； 肺腫瘤，分期

並列摘要

Small-cell bronchogenic carcinoma is known to have distinct biological and clinical behavior, manifested by a rapid doubling time in vitro. Though a central mass representing metastases to hilar or mediastinal lymph nodes is a most typical roentgenographic finding, other rare circnmstances may occur. Computed tomography provides detailed information about each lung cancer and its staging. Seventy-three untreated patients with proved small-cell bronchogenic carcinoma were evaluated with thoracic CT between 1987 and 1993. For purpose of this study, small-cell bronchogenic carcinoma was classified into subtypes according to tumor location and the distribution of lymph node enlargement. Distribution of lymphadenopathy in the mediastinal compartments designated by the American Thoracic Society was assessed.
The stations most commonly involved were right lower paratracheal (station 4R) and right hilar (station 11 R) with 39 cases (53%) each. The most common subtype is a central lesion with either mediastinal or hilar adenopathy (79.4%). The second is a peripheral lesion with either mediastinal or hilar adenopathy (13.7%). The third is a solitary pulmonary nodule without mediastinal and hilar adenopathy (4.1%). The least common subtype showed an infiltrative lesion in two cases (2.7%). Also assessed was the frequency of other findings including pleural effusion, displacement or narrowing of either the tracheobronchial tree or major vessels, adrenal metastasis, liver metastasis, atelecatsis, chest wall invasion, rib destruction and lung apex fibrotic scars.

並列關鍵字

Lung neoplasms, CT ； lung neoplasms, staging