肺癌侵犯肺动脉干19例  

Invasion of pulmonary artery trunk by pulmonary carcinoma: review of 19 cases

作　　者：马游[1] 黄偶麟[2] 孙德魁[2] 

机构地区：[1]南京市解放军第454医院,210002 [2]上海胸科医院北六病区

出　　处：《中国局解手术学杂志》2000年第1期35-36,共2页

摘　　要：目的 观察肺癌侵犯肺动脉干的病理解剖、CT征象,为手术提供参考。方法 对19例肺癌侵犯肺动脉干的切除标本进行病理解剖,与术前CT比较。结果 肿瘤包绕肺动脉干全周8例,部分包绕11例。肿瘤侵犯以管壁外膜和中膜为主,尤其局限在中膜的外弹性膜周围,内膜未受侵。管壁炎性浸润、水肿或肉芽及结缔组织增生突出。CT表现管周脂肪异常10例,肿块与肺动脉干紧密相贴或包绕16例,压迫及移位2例,低肺血流灌注3例。结论 CT诊断肺癌侵犯肺动脉干有一定局限性,肺动脉干受侵犯者仍可手术。Objective To study the correlation between the pathological change and manifestation on CT scan when pulmonary artery trunk was invaded by pulmonary carcinoma, in order to provide a reference for surgical treatment. Mehtods Tumor tissue was obtained during surgery in 19 cases when pulmonary artery trunk was invaded by carcinoma. Pathological studies were carried out, the results of which were compared with patients' pre-operative CT scan. Results Pulmonary artery trunk was totally enclosed in tumor tissue in 8 cases, partially enclosed in tumor tissue in 11 cases. Histologically, carcinoma invasion was mainly localized in adventitia and medium layer, especially loalized around the outer elastic membrane of the medium layer of the pulmonary artery wall. None of the epithelium of all cases was invaded by tumor cells. Meanwhile, inflammatory infiltration, edema, granulation tissue and connective tissue proliferation were noticed in histological study. On pre-operative CT scan, abnormal fat tissue was noticed around the pulmonary artery in 10 cases. Pulmonary arteries were tightly involved with tumor mass, or enclosed in tumor mass in 16 cases, 2 of wliich were compressed or shifted by tumor mass. Low pulmonary blood perfusion was found in 3 cases. Conclusion Pre-operative CT scan was of limited value for the diagnosis of invasion of pulmonary artery trunk by pulmonary carcinoma. There is still a possibility for total resection when pulmonary artery trunk is involved in tumor mass.

关 键 词：肺肿瘤 肺动脉 CT 病理解剖 

分 类 号：R734.202[医药卫生—肿瘤]