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1、肺癌与肺结核 的影像学诊断肺癌分类Lungcancer,bronchogeniccarcinoma病理分型：鳞、小、腺、大临床分型：中央型、周围型、纵隔型SquamouscellCa30-40%，generallycentral(70%hilarorperihilarinsubsegmentalorlargerbronchi)strongassociationwithcigarettesmokingabout15%bronchogeniccarcinomasarecavitary,andofthese,nearly60%ares
2、quamouscelllesions,walltypicallythickandnodularintralumenalgrowthpattern-oftenresultingindistalatelectasisorpost-obstructivepneumonitis(anon-infectiousprocess).thelowestfrequencyofdistantmetastases,spreadstoinvolvelocalnodesbydirectextensionthemostfavorableprognosisH
3、ypertrophicosteoarthropathyadenocarcinomaascommonassquamouscellcarcinoma(30-40%).generallyperipheral(75%)uncommonlycavitatecommonlymetastasizesearlytolymphnodes,thepleura,adrenalglands,CNS,andbone.SmallcellCa15-20%ofprimarylungmalignanciesthestrongestassociationwithc
4、igarettesmokingthemostlikelytoproduceectopichormones-mostcommonlyresultinginCushingssyndrome(ACTH)orsyndromeofinappropriateantidiuretichormone(SIADH)generallycentral(85-90%withinalobarormainstembronchi)andhasatendencytoinvadelongitudinallyalongthebronchialwall,inasub
5、mucosalandintramuralfashionInternalnecrosisiscommon,butcavitationisextremelyraretheworstprognosis,despitetypicallygoodresponsetoinitialchemotherapyLargeCellCaonly5-10%stronglyassociatedwithcigarettesmokingtypicallyperipheralandgenerallylarge(over4to6cm),withrapidgrow
6、th,earlymetastases,andapoorprognosisPancoasttumorapicaldensity(superiorpulmonarysulcus)destructionoradjacentriborvertebraHorner'ssyndromepaininarmusuallybronchogenicCa(squamoustype)also:mets,malignantneurogenictumor影像诊断目的：明确诊断，TNM分期手段：X线平片、CT、MRI、PET等T1:Atumorlesstha
7、norequalto3cmingreatestdimension,surroundedbylungorvisceralpleura,withoutbronchoscopicevidenceofinvasionmoreproximalthanthelobarbronchus(i.e.,notinthemainbronchus).TUMORT2:Atumorwithanyofthefollowingfeatures:i)Largerthan3cminlargestdimensionii)Associatedwithatelectas
8、isorpost-obstructivepneumonitisthatextendstothehilarregion,butdoesnotinvolvetheentirelungiii)InvadesthevisceralpleuraT3:Atumorofany
