The MSCT Features And The Relationship With Bronchus Of Malignant Solitary Pulmonary Nodule

Part Ⅰ The MSCT features and the relationship withbronchus of malignant solitary pulmonary nodule【Objective】To compare the MSCT features of pure ground-glass nodule, mixedground-glass nodule and solid nodule of malignant solitary lung lesions less than3cm in order to improve the diagnosis ability and learn the mechanism of thedevelopment of malignant lung lesions.【Materials and Methods】Retrospectively analyzed the clinical data and MSCT performance of142malignant solitary lung nodule(pGGN15cases, mGGN73cases, solid nodule54cases).The MSCT signs include the shape, margin, interface, internal characteristics,adjacent structure. Differences were analyzed by using the R×C chi-square test andFisher exact test.【Results】There were no differences in shape, interface, adjacent structure among thefGGN, mGGN and the solid nodule. The margin(speculation, spine-like process),internal characteristics(CT bronchogram sign) were difference among the threegroups. For the speculation sign, differences were found between solid nodule vspGGN and mGGN. For the spine-like process, differences were found between solidnodule vs mGGN. For the typeⅠbronchogram sign, differences were found betweensolid nodule vs pGGN and mGGN. For the type Ⅲ bronchogram sign betweensolid nodule vs mGGN.【Conclusion】With the increase of the solid ingredients in the nodule, spiculation, spine-likeprocess, bronchial cutoff in the lesion and bronchial running rigidly in the lesionshowed an increasing trend. This may reflect the development process of malignanttumors of the lung. Part Ⅱ The CT and pathological performance ofmucin-producing pulmonary adenocarcinoma【Objective】The purpose of our study was to investigate the CT and pathological features ofprimary pulmonary colloid adenocarcinoma in order to improve the diagnosis ability.【Materials and Methods】We retrospectively analyzed13histopathologically confirmed patients(7men,6women;mean age,56years;range,36-74years) on CT.11of the patients receivedenhancement scan.8patients performed immunohistochemical study, the analysisindicators include CK7,CK20and TTF-1.【Results】11of13patients were single lesions,2patient showed metastatic tumors inboth lungs on CT.3were central.9lesions were round nodules or masses,3lesionswere irregular,1was presented as consolidation.11lesions showed lobulation. Onplain scanning findings,7lesions showed cystic-solid opacities,4lesions showedsolid opacities,2lesions showed mixed ground glass opacities. On enhancementscanning findings,3lesions showed no enhancement,4lesions showed mildenhancement,4lesions showed mild to moderate inhomogeneous enhancement.3tumors had ground-glass opacities around the lesions and showed poorly defined.Two cases showed multiple nodules and patchy shadows. Under the microscope wecan see “mucus lake”, some tumor cells float in the lake. The positive rate of theexpression of CK7, CK20and TTF-1were77.8%（7/9）、55.6%（5/9）、77.8%（7/9）respectively.【Conclusion】Primary pulmonary colloid adenocarcinoma have specific characteristic on CTand may be helpful for diagnosis before operation. Besides, the lesions showed highexpression of CK7,CK20and TTF-1. The final diagnosis depends on pathology.