6-1.肺癌诊断-课件.pptVIP

* 患者女性，腺癌，表现为剧烈头痛、恶心和呕吐。（左侧）头部增强MRI提示左侧颞叶孤立脑转移和软脑膜不规则强化。CSF压力明显升高，找到肿瘤细胞。（右侧）为治疗后，可见软脑膜不规则强化减轻。治疗方法为Iressa联合泰道。 * 左上叶病灶穿刺为腺癌，患者以脑转移和脑膜转移起病。 * 男性70岁，ct发现左上肺战位，手术病理提示腺癌，分期为T2N0M0。1年4月后发现右上肺占为，仔细观察原ct已经有右上肺病灶。 * This is a 64years old, male, Sputum cytology revealed suspicious for malignancy. Swelling at the bifurcation of Rt B7and B8 were seen under white light examination and magenta image on an abnormal area was identified by AFI. The pathological diagnosis was moderate dysplasia. * * Lung cancer is staged according to three parameters: tumour (T), lymph nodes (N) and metastatic involvement (M).1 For each of these, x indicates that the value cannot be assessed and 0 indicates that no evidence of the parameter is found. Additional stages are outlined below. Tumour stages: TIS: carcinoma in situ (confined to airway lining) T1-T4: ranging from tumour 3 cm in greatest dimension through to tumour of any size that invades the mediastinum, heart, great vessels, trachea, oesophagus, vertebral body or carina. Lymph node stages: N1: metastasis to ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes involved by direct extension of primary tumour N2: metastasis to ipsilateral mediastinal and/or subcarinal lymph node(s) N3: metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node(s). Distant metastasis stages: M1: distant metastasis present. The schematic diagram shows examples of some tumour stages: Early stage 0 (carcinoma in situ): tumour is confined to the airway lining stage IA (T1 N0 M0): tumour has spread to nearby lung tissue but has not reached the main bronchus Localised stage IIB (T2 N1 M0/T3 N0 M0): tumour has reached main bronchus and local lymph nodes or direct local invasion into chest wall, diaphragm, mediastinal pleura or parietal pericardium Advanced stage IIIB (T4 Any N M0/Any T N3 M0): tumour has invaded chest wall, trachea and the contralateral ly