ABSTRACT
<p><b>OBJECTIVE</b>To analyze the CT image features of pneumonic-type lung cancer and to reduce misdiagnosis.</p><p><b>METHODS</b>The CT findings of 46 patients with pneumonic-type lung cancer were retrospectively reviewed, and CT image in the differential diagnosis of this special kind of disease was evaluated.</p><p><b>RESULTS</b>According to the extent of lesion, these cases were divided into two groups: multi-lobe consolidation group and single lobe consolidation group. The lesions in the latter group located in the upper, middle or lower lobe, respectively. Twenty-nine cases had homogeneous consolidation lesion, 14 cases showed single or multiple cysts and cavities in the lesions, 3 cases exhibited localized low density in the lesion. Forty-one cases shown the sign of air bronchogram with presentation of narrow air bronchogram in 25 of those. Forty cases showed well or ill defined ground-glass opacitiy surrounding the consolidation lesion. Fifteen cases had multi-nodules or opacities distributed in centrilobular or centric bronchiolar location. Of the 30 patients who received contrast medium, 23 showed distinct enhancement, and 7 showed indistinct enhancement with a positive CT angiogram.</p><p><b>CONCLUSION</b>CT findings including lower lobe distribution, homogeneous consolidation, narrow air bronchogram, well defined ground-glass and CT angiogram are helpful in differentiating pneumonic-type lung cancer from various kinds of infection. However, most of CT manifestations of pneumonic-type lung cancer are not specific. Therefore, it's necessary to combine CT findings with other clinical data when making diagnosis.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Adenocarcinoma , Diagnostic Imaging , Adenocarcinoma, Bronchiolo-Alveolar , Diagnostic Imaging , Adenocarcinoma, Mucinous , Diagnostic Imaging , Adenocarcinoma, Papillary , Diagnostic Imaging , Diagnosis, Differential , Diagnostic Errors , Follow-Up Studies , Lung , Diagnostic Imaging , Lung Neoplasms , Diagnostic Imaging , Pneumonia, Bacterial , Diagnostic Imaging , Radiographic Image Enhancement , Tomography, X-Ray Computed , Methods , Tuberculosis, Pulmonary , Diagnostic ImagingABSTRACT
Objective To analyze the CT findings of endobronchial spread in lung adenocarcinoma. Methods The CT findings of 15 lung adenocarcinomas or bronchioloalveolar carcinomas with endobronchial spread were reviewed,the distribution and the progression of the spread were evaluated.Results All of the primary tumors were consolidation form.The spread lesions distributed in one side of the lung or both sides along the bronchus.The pleural surface was spared.The CT findings of the spread included centrilobular nodules(n=5),tree-in-bud(n=7),acinar nodules(n=2),ground-glass opacities(n=10)and air- space consolidations(n=13)in the first CT examination.5 cases of the spread lesions only presented centrilobular nodules(single form)and 10 cases presented several appearances(complex form).All of the cases were diagnosed as tuberculosis or pneumonia,and antituberculotic or antibiotic therapy was taken with no effect.The follow-up CT scans showed progression in all cases,and the spread lesions with single form became multiple consolidations.The spread lesions with complex form deteriorated faster than the single one. Conclusion Although the CT findings of the endobronchial spread of the lung adenocarcinoma is specific, the clinical history and laboratory examination also are important for the differential diagnosis with tuberculosis and other infectious diseases.