西安交通大学医学院呼吸系统疾病课件 Primary Bronchogenic Carcinoma.pptVIP

Primary Bronchogenic Carcinoma Malignant lung tumor arised from the respiratory epithelium. Laboratory examination: X-ray: Central carcinoma: Direct imaging: round shadow with a coarse border or lobulated mass. unilateral irregular hilar mass. Indirect imaging: atelectasis, obstructive pneomonia, local emphysema. Tomogram or bronchogram: irregular thickening ,narrow and block of the bronchus or the mass in the bronchus. Others: enlargement of the hilar lymph node, mediastenal mass, paralysis of diaphragm resulting in conflict movement and elevation of diaphragm, pericardial effusion Peripheral carcinoma: a small patch of localized shadow with an unclear border and light density in the early stage. then appeared as an enlarged round mass with an increased density and a clear border, often are lobulated, has notch or spicule especially thin and variable sized spicule. Carcinomatous cavity: thick wall, often eccentric, irregular and unsmoth inner wall with a fluid level. Others: infiltration of the ribs, pleural effusion. Bronchoalveolar carcinoma: nodular :just the same as peripheral carcinoma, dispersed: nodular disseminated lesions with variable size, clear border and heavy density, accompanying with heavy reticular shadow. Computer tomography(CT): detect lesion ≥ 3mm. Identify enlarged lymphnode, pleural lesion and some hidden lesion in the common chest film. Magnetic resonance imaging(MRI): detect lesion ≥ 5mm. Make sure the relaton between the lesion and vessel or the chest wall. single photon emission computerized tomography（SPECT） Tumor positive radionuclide imaging Tumor radioimmunoimaging Positron emission tomography (Pet) Detect local tissue cell metabolism Clinical Manifestation Symptoms of carcinoma can be divided into four groups: Those caused by tumor growing locally Those caused by tumor invading adjacent structures Those caused by metastatic disease Paraneuplastic syndromes Local Cough Hemoptysis Wheezing or stridor Ch