病例分析及文献复习.pptVIP

the measurement of the cavity wall thickness at its thickest section was most useful in predicting whether the cavity was of malignant versus nonmalignant etiology. 4 mm or less：94%benign 5 to 15 mm：60%benign 15 mm or more ：(35/39 [90%]) malignant Cavity and lung cancer Cavitation detected by plain radiography has been noted in 7 to 11% of primary lung cancers, while cavitation detected by computed tomography has been reported for up to 22% of primary lung cancers. cavitation is more frequently found among cases of squamous cell carcinomas than other histological types . Cavity and lung cancer THANK YOU! 肿瘤最大径5mm，经常在浸润性肺腺癌边缘 * 5mm,20mm * FIGURE 4. A, Atypical imaging of MIA. A part-solid subpleural nodule in the right lower lobe containing internal air bronchograms was suspicious of a small invasive adenocarcinoma. This increased in size on follow-up and was resected. B, Pathological specimen, HE stain, of the resected nodule demonstrates an invasive focus in nonmucinous MIA. This high-power view shows desmoplasia in relation to small invasive acini seen in a small 5-mm scar within a lepidic lesion that would otherwise have amounted to AIS. * FIGURE 4. A, Atypical imaging of MIA. A part-solid subpleural nodule in the right lower lobe containing internal air bronchograms was suspicious of a small invasive adenocarcinoma. This increased in size on follow-up and was resected. B, Pathological specimen, HE stain, of the resected nodule demonstrates an invasive focus in nonmucinous MIA. This high-power view shows desmoplasia in relation to small invasive acini seen in a small 5-mm scar within a lepidic lesion that would otherwise have amounted to AIS. * 病例分析 呼吸与危重症医学科 陈文慧 2013年5月16日 病例特点 中年男性，慢性病程，一般情况好，无明显消瘦 主要症状：咳嗽、咳痰，无发热 胸CT：右下肺空洞，有液平，洞壁不光滑，双肺可见渗出右中叶小结节，呈逐渐融合 2次支气管镜病原学及细胞学均阴性 T-SPOT、G-试验阴性 空洞壁穿刺病理：纤维组织增生伴淋巴细胞浸润 抗感染治疗3月余无效 肺空洞性病变 感染性疾病-真菌感染 细菌性感染 结核感染 真菌感染 寄生虫感染 ╳ ？ 非感染性疾病 肿瘤 肺血管炎性疾病 结缔组织疾病相关肺病变 肺间质性疾病 ╳ ？ 肺穿刺病理 高分化腺癌？ 外科胸腔镜病理 腺癌！ Lung ade