胸片上“扫帚征”对左上肺中央型肺癌的诊断价值  

An Important Diagnostic Work up Broom Sign on Sternum of Left top Lobe Central Lung Cancer.

作　　者：肖海清[1,2] 熊曾[2] 曾纪珍[2] 

机构地区：[1]湖南省长沙市第三医院放射科,410015 [2]中南大学湘雅医学院放射科

出　　处：《中华临床医学杂志》2007年第6期5-8,共4页Chinese Journal of Clinical Practical Medicine

摘　　要：目的提高对“扫帚征”这一重要肺癌征象的认识，降低胸部平片的漏诊和误诊率，尽早发现肺癌并早期干预，改善肺癌的预后。方法对6例左上叶中央型肺癌进行平片和CT的分析，结合支纤镜、手术及病理检查。结果胸部平片示左肺门向尖后段呈扇形放射状分布的粗条索影和左肺门肿块。CT扫描示左肺门区肿块，周围可有小片状及条索状影，左上叶尖后段支气管壁可有增厚，纵隔可见肿大淋巴结。病理结果均为肺癌，其中，小细胞癌3例，腺癌1例，鳞癌2例。结论“扫帚征”是左上叶中央型肺癌的一个重要征象，对该征象的充分认识，可以降低平片的漏诊和误诊率，改善肺癌患者的预后，具有重要的意义。Objective The important diagnostic work up broom sign on plan film for the left top lobe central lung cancer was evaluated. Methods Routine sternum and CT and bronchoscopy and biopsy were performed for 6 patients with left top central lung cancer, which were surgery and pathology confirmed. Results All of their sternums displayed the neoplasm of left hilum was accompanied with a coarse actinomorphous like sector image extended from the hilum to the left apicoposterior segment. CT exhibited left hilum mass with surrounding patched and striated images. There were thickening of the bronchal walls of the affected segment and enlarged midiasternal lymph nodes also. They were all pathologically confirmed malignant after surgical resection. Three were small cell carcinoma, 1 adenocarcinoma and 2 squamous carcinoma. The pathology of broom sign was interstitial malignant infiltration. Conclusion Broom sign on sternum is an apparent signor left top central lung cancer presented before the occlusion of the bronchus, and its importance is never overemphasized for the reviewers to decrease miss-diagnosis and to improve prognosis.

关 键 词：扫帚征 中央型肺癌 左上叶 尖后段诊断影像 

分 类 号：R734.2[医药卫生—肿瘤]