肺癌肿瘤分期与CT影像学表现

T1
Example 1: This is an example of a right lung T1 lesion (in this case an adenocarcinoma). The tumor measures 2.4 cm in size and is completely surrounded by lung.
Example 2: This is an example of a T1 lesion in the left lung (the nodular density in the right lung anteriorly [blue arrow] is the inferior margin of the right clavicular head). The tumor measures 1.8 cm in size and is completely surrounded by lung. A thin linear density radiates to the pleural surface from the lesion- this is referred to as a "pleural tag" which is felt to represent tumor-induced thickening of the interlobular septa. There is a focal triangular-shaped pleural-based density identified at the insertion of the "pleural tag" (black arrow). This finding is felt to be secondary to the desmoplastic reaction incited by the tumor. There is retraction of the visceral pleura towards the lesion, and a small quantity of fluid collects within the space formed between the visceral and parietal pleura producing the finding identified on computed tomography. The finding does not indicate visceral pleural invasion.
肺癌的肿瘤分期及 CT影像学表现
T1
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).
T2
ii) Associated with atelectasis or postobstructive pneumonitis that extends to the hilar region, but does not involve the entire lung In this patient with squamous cell carcinoma, there is an endobronchial lesion at the origin of the left upper lobe bronchus (blue arrow)ch has caused the left mainstem bronchus to assume a more horizontal course. The atelectasis extends to the hilar region, but does not involve the entire left lung.
iii) Invades the visceral pleura
i) Larger than 3 cm in largest dimension This large squamous cell carcinoma measures 5.4 cm in transverse dimension. Linear densities radiate to the pleural surface from the lesion. There is a focal pleural-based density identified laterally (blue arrow), but the underlying subpleural fat is not disrupted. This finding is likely due to the desmoplastic reaction incited by the tumor. As previously discussed, retraction of the visceral pleura towards the lesion permits the development of a potential space between the visceral and parietal pleura. A small quantity of fluid within the space can produce a soft-tissue opacity between the lesion and the pleural surface.
T1
T2
T2: A tumor with any of the following features: i) Larger than 3 cm in largest dimension
ii) Associated with atelectasis or post-obstructive pneumonitis that extends to the hilar region, but does not involve the entire lung