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Objective To analyze the relationship between CT image characteristics and the pathological subtypes of small lung adenocarcinoma (≤3 cm) with ground-glass opacity(GGO).Methods Two hundred and three cases of small lung adenocarcinoma proved by pathology were collected.Use the 2015 World Health Organization(WHO) classification of lung cancers as pathology standard.The relationship between CT findings and pathologic classification were analyzed statistically.Results There was a positive correlation between CT type and pathological type (rs =0.756).The size of atypical adenomatous hyperplasia(AAH),adenocarcinoma in situ(AIS) and minimally invasive adenocarcinoma(MIA) lesions were smaller than invasive adenocarcinoma(IAC).AAH lesions were smaller than MIA(P＜0.008 3).However,there were no significant size differences in AAH and AIS lesions,or in AIS and MIA lesions (P＞0.008 3).The critical point of non-or-little-invasive (AAH,AIS and MIA) and IAC was 15.35 mm (sensitivity 80.8％,specificity 90.4 ％).Differences in lobulation,air bronchogram,vacuole sign,pleural indentation and vascular convergence among pathological types were statistically significant (P ＜0.05).Differences in shape,speculation and cavity among groups were not significant (P ＞0.05).Conclusion The higher CT type,lower GGO content and bigger lesion size are all associated with increasing tumor degree of malignancy.The size of IAC lesion is usually greater than 15.35 mm.Lobulation,air bronchogram,vacuole sign,pleural indentation and vascular convergence can help to diagnose IAC.
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OBJECTIVE: To investigate the changes of iron metabolism index in patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds after ending iron dust exposure for 10 years. METHODS: A total of 22 patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds were selected as study subjects.They were misdiagnosed as electric welder's pneumoconiosis in 2004-2006. After ending exposure to iron dust for 10 years,high k V X-ray photography and computed tomography of chest were conducted. Indicators of serum iron metabolism,blood routine and blood biochemical were examined. Six patients were randomly selected to detect genes of hereditary hemochromatosis. The study subjects were divided into observation group( 13 patients) and control group( 9 patients)according to the lung examination. RESULTS: The median of serum ferritin( SF) was 858. 2 μg/L. The over standard rate of SF was 77. 3%( 17/22),and the iron overload was seen in 40. 9%( 9/22) of patients. The over standard rate of serum total iron binding capacity( TIBC) was 22. 7%( 5/22). The over standard rate of serum iron was 4. 5%( 1/22).The SF level of observation group was higher than that of the control group( P < 0. 05). The SF was positively correlated with alanine aminotransferase( ALT)( P < 0. 05). The serum TIBC was positively correlated with prealbumin( P <0. 05). The serum iron were positively correlated with ALT and aspartate aminotansferase respectively( P < 0. 05). But the above 3 iron metabolism indices were not correlated with the blood routine indices,blood glucose and C-reactive protein( P > 0. 05). The six patients tested for genes of hereditary hemochromatosis were excluded from disease. CONCLUSION: There were iron metabolism abnormalities in patients with occupational pulmonary thesaurosis induced by dust of iron and iron compounds,which is related to the iron deposition in lung.
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Objective To improve the recognization and the diagnostic accuracy of brachial cleft cyst (BCC) by CT scan. Methods CT findings of 10 BCC proved surgically and pathologically were retrospectively reviewed. Results BCC，CT number 22～33 Hu；with the enhanced wall and the non-enhanced cystic part. If infections exist，the margin would be obscure and the internal density be increased. These cysts commonly located in the anterior triangle area of the neck or along the anterior border of the sternocleidomastoid muscle. The first brachial cleft fistula was not displayed. Conclusion CT scan can not only clearly show the location，enhanced characters and the relationship to the adjacent tissues of the BCC，but also can be possible to make the diagnosis of the BCC，but not the brachial cleft fistula.