肺癌与肺结核学习教案

1、会计学1肺癌肺癌(fi i)与肺结核与肺结核第一页，共36页。第1页/共35页第二页，共36页。第2页/共35页第三页，共36页。wintralumenal growth pattern- often resulting in distal atelectasis or post-obstructive pneumonitis (a non-infectious process). wthe lowest frequency of distant metastases, spreads to involve local nodes by direct extensionwthe most fa

2、vorable prognosis wHypertrophic osteoarthropathy 第3页/共35页第四页，共36页。第4页/共35页第五页，共36页。第5页/共35页第六页，共36页。第6页/共35页第七页，共36页。第7页/共35页第八页，共36页。第8页/共35页第九页，共36页。第9页/共35页第十页，共36页。T1: A tumor less than or equal to 3 cm in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence

3、of invasion more proximal than the lobar bronchus (i.e., not in the main bronchus).TUMOR第10页/共35页第十一页，共36页。第11页/共35页第十二页，共36页。T2: A tumor with any of the following features:i) Larger than 3 cm in largest dimension第12页/共35页第十三页，共36页。ii) Associated with atelectasis or post-obstructive pneumonitis that

4、 extends to the hilar region, but does not involve the entire lung第13页/共35页第十四页，共36页。iii) Invades the visceral pleura第14页/共35页第十五页，共36页。T3: A tumor of any size that directly invades any of the following: the chest wall (including superior sulcus tumors), diaphragm, mediastinal pleura, parietal peric

5、ardium; or tumor in the main bronchus less than 2 cm distal to the carina (but without involvement of the carina); or tumor associated with atelectasis or obstructive pneumonitis of the entire lung.第15页/共35页第十六页，共36页。第16页/共35页第十七页，共36页。T4: A tumor of any size that invades any of the following: media

6、stinum, heart, great vessels, trachea, esophagus, vertebral body, carina; or any tumor with a malignant pleural or pericardial effusion; or with satellite tumor nodules within the ipsilateral primary-tumor lobe of the lung.第17页/共35页第十八页，共36页。第18页/共35页第十九页，共36页。 第19页/共35页第二十页，共36页。Regional Lymph Node

7、 Status (N) N1: Ipsilateral peribronchial or hilar nodal metastases; or intrapulmonary nodes involved by direct extension of the primary tumor. All N1 nodes lie distal to the mediastinal pleural reflection. 第20页/共35页第二十一页，共36页。N2: Ipsilateral mediastinal and subcarinal lymph nodal metastases. Midlin

8、e pre-vascular and retrotracheal nodes are considered ipsilateral 5, while nodes to the contralateral side of midline are considered N3 第21页/共35页第二十二页，共36页。N3: Contralateral mediastinal or contralateral hilar nodal metastases; also includes ipsilateral or contralateral scalene or supraclavicular nod

9、es. Other cervical nodes are classified M1 第22页/共35页第二十三页，共36页。Distant Metastasis (M)M0: No distant metastasis M1: Distant metastasis present; or separate tumor nodules in the ipsilateral nonprimary-tumor lobes of the lung. Separate tumor nodules in the contralateral lung are considered M1 if they a

10、re of the same histologic cell type as the primary lesion. A contralateral lung tumor with a different cell type is considered a synchronous primary lesion and should be staged independently 第23页/共35页第二十四页，共36页。第24页/共35页第二十五页，共36页。原发肺结核原发肺结核原发综合原发综合征征第25页/共35页第二十六页，共36页。支气管淋巴结结核支气管淋巴结结核(jih) tubercu

11、losis of bronchial lymph nodes原发肺结核原发肺结核第26页/共35页第二十七页，共36页。肺浸润肺浸润(jnrn)及增殖及增殖infiltration and proliferation浸润浸润(jnrn)肺结肺结核核第27页/共35页第二十八页，共36页。2、TB浸润、空洞浸润、空洞(kngdng)及支气管播散及支气管播散infiltrative pulmonary tuberculosis with cavity 浸润浸润(jnrn)肺肺结核结核第28页/共35页第二十九页，共36页。第29页/共35页第三十页，共36页。第30页/共35页第三十一页，共36页。结核结核(jih)球球tuberculoma浸润浸润(jnrn)肺肺结核结核第31页/共35页第三十二页，共36页。断层断层(duncng)片片tomography第32页/共35页第三十三页，共36页。急性急性(jxng)粟粒性粟粒性TBMiliary TB血行