原发性支气管肺癌BronchiogenicCarcinoma原发性支气管肺癌BronchiogenicCarcinoma起源于支气管上皮、腺体或细支气管及肺泡上皮起源于支气管上皮、腺体或细支气管及肺泡上皮分为:鳞癌(50%)未分化癌(40%)腺癌(2%)细支气管肺泡癌(2%)按发病部位分Siteoforigin:中心型、外围型(段支气管以下)生长方式:管内型、管壁型、管外型分为:鳞癌(50%)未分化癌(40%)腺癌(2%)细支气管肺泡癌(2%)按发病部位分Siteoforigin:中心型、外围型(段支气管以下)生长方式:管内型、管壁型、管外型中心型肺癌X线表现中心型肺癌X线表现早期:局限于粘膜内,可无异常发现随后管腔变窄引起阻塞性肺气肿和阻塞性肺炎,甚至阻塞性肺不张病变向腔外生长或肺门淋巴结转移形成肺门肿块早期:局限于粘膜内,可无异常发现随后管腔变窄引起阻塞性肺气肿和阻塞性肺炎,甚至阻塞性肺不张病变向腔外生长或肺门淋巴结转移形成肺门肿块中心型肺癌X线表现中心型肺癌X线表现中心型肺癌CT线表现中心型肺癌CT线表现支气管管腔内软组织肿块Intraluminalsofttissuemass支气管管腔狭窄、变形或阻断Interruption,deformationorconstrictionofthebronchi支气管管壁不规则增厚Thebronchialwallisthickandirregular常伴有相应的肺叶或肺段不张,阻塞性肺炎Localemphysema,atelectasisandpneumonia支气管管腔内软组织肿块Intraluminalsofttissuemass支气管管腔狭窄、变形或阻断Interruption,deformationorconstrictionofthebronchi支气管管壁不规则增厚Thebronchialwallisthickandirregular常伴有相应的肺叶或肺段不张,阻塞性肺炎Localemphysema,atelectasisandpneumoniaIntraluminalsofttissuemass.Thebronchialwallisthickandirregular.LocalpneumoniaIntraluminalsofttissuemass.Thebronchialwallisthickandirregular.Localpneumonia外围型肺癌X线表现外围型肺癌X线表现早期:呈小片状浸润影或轮廓模糊的结节状或球形病灶(直径<2厘米),GGO(Ground-GlassOpacity)随后发展成球形肿块,密度高而均匀,边缘呈分叶,伴细短毛剌及脐状切迹中心可坏死形成癌性空洞发展较快,倍增时间平均为78~88天早期:呈小片状浸润影或轮廓模糊的结节状或球形病灶(直径<2厘米),GGO(Ground-GlassOpacity)随后发展成球形肿块,密度高而均匀,边缘呈分叶,伴细短毛剌及脐状切迹中心可坏死形成癌性空洞发展较快,倍增时间平均为78~88天外围型肺癌X线表现外围型肺癌X线表现外围型肺癌CT线表现外围型肺癌CT线表现大小不等类圆形或分叶状肿块lobulated,roundedorovalsolitarymasswithdifferentsize肿块内可有液化、坏死Liquefactionandnecrosisinthemass肿块密度均匀或不均Homogenousorinhomogenous肿块边缘有细短毛刺spiculatedsignattheborderofmass增强扫描后,肿块有强化改变Aftercontrastenhancement,themassisenchanced大小不等类圆形或分叶状肿块lobulated,roundedorovalsolitarymasswithdifferentsize肿块内可有液化、坏死Liquefactionandnecrosisinthemass肿块密度均匀或不均Homogenousorinhomogenous肿块边缘有细短毛刺spiculatedsignattheborderofmass增强扫描后,肿块有强化改变Aftercontrastenhancement,themassisenchancedspiculatedsignlymphadenopathy外围型肺癌CT线表现外围型肺癌CT线表现毛刺征毛刺征瘤内钙化瘤内钙化癌性空洞癌性空洞分叶和脐样切迹分叶和脐样切迹女性,28岁,颈部不适女性,28岁,颈部不适转移性肺癌X线表现转移性肺癌X线表现原发灶:常为绒癌、肝癌、骨肉瘤、肾癌、胃癌、乳癌。alltheosteosarcoma,carcinomaofthebreast,kidney,ovary,liver,gastrointestinaltract,etc血行转移:多发球形病变,密度均匀,大小不一,轮廓清楚似棉球状,以二中、下肺野较多,少数可单发multiplenodulesofvaryingsizeandattenuation,fewormanyinnumber淋巴转移:自肺门向外呈放射状分布的索条状影,并呈串珠状改变Inadditiontothehilarenlargement,thereisanirregularnetworkofdensityextendingoutwardfromthehilarintotheparenchyma原发灶:常为绒癌、肝癌、骨肉瘤、...