精品肺癌与肺结核的影像学诊断课件.ppt

肺癌与肺结核的影像学诊断;肺癌分类;Squamous cell Ca;;adenocarcinoma;Small cell Ca;generally central (85-90% within a lobar or mainstem bronchi) and has a tendency to invade longitudinally along the bronchial wall, in a submucosal and intramural fashion Internal necrosis is common, but cavitation is extremely rare the worst prognosis, despite typically good response to initial chemotherapy ;Large Cell Ca ;Pancoast tumor;影像诊断;T1: A tumor less than or equal to 3 cm in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than the lobar bronchus (i.e., not in the main bronchus). ;;;ii) Associated with atelectasis or post-obstructive pneumonitis that extends to the hilar region, but does not involve the entire lung;iii) Invades the visceral pleura;T3: A tumor of any size that directly invades any of the following: the chest wall (including superior sulcus tumors), diaphragm, mediastinal pleura, parietal pericardium; or tumor in the main bronchus less than 2 cm distal to the carina (but without involvement of the carina); or tumor associated with atelectasis or obstructive pneumonitis of the entire lung. ;;T4: A tumor of any size that invades any of the following: mediastinum, heart, great vessels, trachea, esophagus, vertebral body, carina; or any tumor with a malignant pleural or pericardial effusion; or with satellite tumor nodules within the ipsilateral primary-tumor lobe of the lung. ;; ?????????????????????????????????????;Regional Lymph Node Status (N) ;N2: Ipsilateral mediastinal and subcarinal lymph nodal metastases. Midline pre-vascular and retrotracheal nodes are considered ipsilateral [5], while nodes to the contralateral side of midline are considered N3 ;N3: Contralateral mediastinal or contralateral hilar nodal metastases; also includes ipsilateral or contralateral scalene or supraclavicular nodes. Other cervical nodes are classified M1 ;Distant Metastasis (M) M0: No distant metastasis M1: Distant metastasis