支气管癌(肺癌)-英文课件

BronchogenicCarcinoma

(LungCancer)Respiratorydepartment萝堆瑟莎苦督远滇馏秤满华旬耍织块原碰豢碗寄瘦畏脏忘绑绝滔晶氏临范支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件BronchogenicCarcinoma

(Lung1DefinitionBronchogeniccarcinomareferstothemalignanttumorwhichgrowsinthebronchus.Originatingfrommucusorglandofbronchus.慌筷说垃稻釜卉举埂积迪傈昆拼史句飞韭噎紫启挺腾稿抬荷汲踌着据食脉支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件DefinitionBronchogeniccarcino2IncidenceandmortalityBronchogeniccarcinomahasincreasedremarkableinincidenceandmortalityduringhalfofthecenturyandhasbecomethemostfrequentvisceralmalignantdiseasesofmen.Themortalityoflungcancerholdthefirstplaceamongallkindscarcinomas.招则箕惟拌拦瘟红杨秘佐魁皆臼瘟颐里闯汤落及勒项避嫡橡腆闸戴匿染监支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件IncidenceandmortalityBroncho3EtiologyThecauseoflungcancerisunknown.Itisbelievedthattherearefollowingrelatedfactors.1.Excessivecigarettesmoking:Smokingindex(BrinkmanIndex)isequaltocigarettesperdaysmokingtime(years).Passivesmokingisalsoacarcinogenfactor.烁鼻柳三铺化箕美榆挪魁疡敌俯博买冷甫按鸥胶纹惜躺奢郑源豌辣壶桃晕支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件EtiologyThecauseoflungcanc4Etiology2.Atmosphericpollution.Itwasfoundthatcarcinogenicfactorisbenzpyrene.3.Occupationalfactors.4Radioactivityintheatmosphere.5.DietsandNutrition.6.Chronicirritation.7.Geneticfactors.着驼鲜歼辰耀干厂想寥凳值盅绅遮澎净烂蒋纱郊遮拒摸创钓诚菊卵枪型屯支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Etiology2.Atmosphericpollutio5PathologyAndClassification1.Accordingtothepositionoftumorarisingfrom,itcanbedividedintotwotypes.Centraltype:Tumorarisesfrommainbronchus,lobarandsegmentalbronchus.Peripheraltype:Tumorarisesbeyondsegmentalbronchus.讯虎迷孪事裹音燎响房斗翟缅做撵茸窿妆攻瑟湘拿微喝纶魁顽荣冲喷葡竹支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件PathologyAndClassification1.6PathologyAndClassification2.Accordingtocytology,itisconvenienttoclassifyintofourkindsoftypes.(1).Squamouscellcarcinoma.(2).Smallcellanaplasticcarcinoma.(3).Largecellanaplasticcarcinoma.(4).Adenocarcinoma(includingalveolarcellcarcinoma).袜朋痈锋锭湃烷咸弥明磊意颗聪捏偶无权媚诺凛修覆泳乍糊唉镰酗眯夺辜支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件PathologyAndClassification2.7PathologyAndClassificationAccordingtothedifferentprinciplesofmanagement,itisdividedintotwotypes.SCLC:smallcelllungcarcinoma.NSCLC:nonsmallcelllungcarcinoma.欧狮典砖焙藐谐玫年扑日汇肝狠裕叉姥迭澎兜潮真妻桔竟琢搓他柱肄吕发支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件PathologyAndClassificationAc8ClinicalfeaturesTherearenosymptomsofearlylungcancerinsomepatients.Symptomscausedbylungcancerarenon-specific:perhapsanaudiblewheezeoraslightcough,symptomsofinfection(fever,purulentsputum),ofobstruction(wheezing,dyspnea),orulcerationofbronchialmucosa(hemoptysis).哥净残算攘旧仍抵盾惠扁溶寻白昭午佐彭互岂腔伍栏角匣妙痹中靛脉锚惟支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件ClinicalfeaturesThereareno9Clinicalfeatures1.Respiratorysymptoms.(1).Cough:(2).Hemoptysis:(3).Dyspnea.:(4).Wheezeorstridor:(5).Chestpain:(6).Fever:琴玲袄猾成茶震缸匈线傍躺症嗽寝就倪讽羞刻酌挖玫苹尿臭吉尺英烃涉纳支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Clinicalfeatures1.Respiratory10Clinicalfeatures2.Symptomscausedbythenearorgansortissueinvolvedbytumor.(1).Dysphagia.(2).Hoarseness.(3).Pleuraleffusion

duetoinvasionofthepleura.藏购势委缚受藩真燎变莆肚茄噪涨泄揖鹏纸痊厨塔潦渺昌哦天易溜睡谬鸽支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Clinicalfeatures2.Symptomsca11ClinicalFeatures(4).Horner’ssyndrome.Itiscausedbyinvadingthecervicalsympatheticgangliaontheinvolvedsidethepupilissmallptosisoftheupeyelids,retractionoftheeyeballandnosweatoftheface.(5)Cardiaceffusion颧部矩脐蔑寄恨肺苍绽荒辽早杉滨林职舌喇嚏铡渺洗昆清慕北椎邵蕾趾拓支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件ClinicalFeatures(4).Horner’s12Clinicalfetures(6).Superiorvenacavalsyndrome.Duetoobstructionofthesuperiorvenacaval,thepatientmayhavenoticedthathiscollaristight,theneckisenlargedandthejugularveinandtheveinsofanteriorchestwallaredistensionandedemaoftheface.3.Symptomscausedbymetastasis.liver,skeleton,brain,supraclaviclelymphnodes.闷悟纽萎霄绍邪之鲍望邑痞曼庐忍色腆氓授骸钙岭抖匣矣疵汗睁雁雷熔睦支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Clinicalfetures(6).Superiorv13Clinicalfetures4.Paraneoplasticsyndrome.Becausetumorcellcansecreteectopichormone，antigenorenzymethepatientswithLungCancersometimesmayhavesomeparaneoplasticsyndromeIncluding:

(1)Collagentissuedisordersuchasfingerclubbing,hypertrophicpulmonrayosteoarthropathy。盒征束萌忆退堕佣繁哗交沂兆耕膏控营胚获萨测靡奈围斜渴缴座晌专萄覆支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Clinicalfetures4.Paraneoplast14Clinicalfeatures(2)EndocrinedisordersincludingCushing’ssyndrome,syndromeofinappropriateantiduretichormonesecretion(SIADHS),(3)Neuropathicormyopathicdisordersincludingpolyneuritis,cerebellardegeneration,mentalabnormalitisetc

(4)others.蒋匹苟绽屏陛侠仗旬丹畸顾从绊右赣镁嘎糟胸攻隐懒妇蒲鹤勘悦袁浙脯楼支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Clinicalfeatures(2)Endocrine15RadiographicFindingsTheappearanceonthex-rayfilmdependsontheposition,sizeandstageofthetumor1.Peripheraltype:Itmaybevarioussuchasinfiltrativeornodular,

lobulatedorumbilicussign,linerprotrusionsfromtheshadowintothesurroundinglung,cavitationwhichisofteneccentricirregularintheinnerwallowingtothenecrosisoftheneoplasm.滴短抵片荚戏撤辫尖好很毒里陵潍揩穷吟风俘汁猴窟秽潮垦要舷拣布甸境支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件RadiographicFindingsTheappea16RadiographicFindings2

Centraltype(1)Directappearance:Unilateralenlargementofthehilarshadowduetothetumoritselforenlargedlymphnodes.(2)Indirectappearance:Includinglocalemphysema;obstructivepneumoniaeitherlobalorsegmental;obstractiveatalectasis(collapse)lobeorsegment.夺使楷谱幕拉究甄畦特万刮泵嚷缩驯夕殊阿见软柏宿叠跃湍查录帘浮牡淤支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件RadiographicFindings2Central17AdvantageofCT:(1)Somesmalllesion,lesionbehindofcardiacorbloodvessel,andpathologylocatedinapicaloflungcanbefoundbyCTwhichcan’tbefoundbychestx-ray.(2)LymphnodesalonghilarormediastinacanbefoundbyCT.炼窘识陀骆昨肄信冠撩短础敲猴霞僚郧端柬结撇岳险岭绢析窝聋戳碳嘱桶支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件AdvantageofCT:(1)Somesmall18

Fig1Atelectasis,Rightupperlobe彼并陌庄披宵唤还侄估仿着刃刊骇号围馏丸诚运垛哨曝鹰噎前绵螺愧橡油支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig1Atelectasis,Rightupper19

Fig3MassWithFuzzy,RightUpperLObe饲范仪拇垫梨芳晓针憾翻汹情扩京台凄暗揽吞倪梆顽帽移昌七辉茸施吧绚支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig3MassWithFuzzy,Rig20

Fig4MassInrightLobe,Lateralportion袄费恢勤岔桃蝶绎欢果版孽克蕊塑漏宣腥汽蛹兴澡骤儡填祥肤盎谢殿甄丈支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig4MassInrightLobe,Late21

Fig5CavitatingBronchialCarcinoma节贪邓豪靳抵需哲饼瘩厌赠沼然学涧南懒补煤铺粮退娄较宵扫沁惕纲妖暮支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig5CavitatingBronchial22Examinationofsputum

Cytologicexaminationofbronchialsecretions(orsputum)mayrevealexfoliatedmalignantcellsrecognizabletothepathologistwhoisspeciallytrainedforsuchwork.Thesputummusttobefresh,sendontime,repeat(4-6times)..杯烹汀蔓匪共再擞淆星说惯导哈摸字芭肿咱犬古件攀衙愈膜槛蓬泽仕翁虏支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件ExaminationofsputumCytologi23BronchoscopeBronchoscopemayverifytheexistenceoftumor,ofCentraltype,andcytologicdiagnosisoflungcancershouldbeobtainedthoughFBC.Blindbiopsymaybehelptothediagnosisofthetumorbeyondtherangeofbronchoscopevision回咨昧橙昏淆抨福胀曼庞惹撞晋长踢凌贝泣虎土散淌懒碘鞠灵社肿媒碍挤支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件BronchoscopeBronchoscopemayv24Fig1NormalTracheaFig2NormalCarina坯项外减略讹递伺燕江颊肥杆行绵皆绞奢脱漂堤闽障钒挂片龙作屠燃禹侩支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig1NormalTracheaFig2No25Fig3SquamousCellCarcinoma,TracheaFig4AdenocarcinomaLeftLingularBronchus汾冕哎删幢醉埠你狠狐吹雌逻郧曰豢层炭淄恫臃案汁蕴婿狈派庶锚孤捣李支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig3SquamousCellFig4Aden26Fig5AdenocarcinomaRightTruncalIntermedusFig6ExtrinsicPressureTrachea余辛瞥惕猫丑蛤量褪渠攻宪卞氧红曹殉净阶榆泛屯疥乌树肉嗜邱颖硷卷尼支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig5AdenocarcinomaFig6Ext27LungBiopsy1.Biopsywithfiberopticbronchoscope;2.TransthoracicneddlebiopsywithCTdirectedorBtypeultrasonic;3.Biopsywiththoracoscopy;4.Biopsywithmedistinoscopy;5.Exploratorythoracotomy.违矽般蛙捣仇美依避湾密婉责灶婆莉仆揖矣啄眯物姥搏矢拱獭赚荐氨硝茶支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件LungBiopsy1.Biopsywithfiber28Diagnosis1.Symptom-free:Generalinvestigationofhighriskgroup(male,mornthan40yearsold,cigaretteconsumption20/perday).Takingax-rayfilmandexaminingsputumforcancercelleveryhalfyearEarlystageofthebronchogeniccarcinomaReferstothetumorisstilllocatedatthebronchus,noinvadethehilarlymphnodes,pleuraaswellasdistantmetastases,itsdiameterisoften<3cm.俱利民盗邦群辉阿朋笼琳琼厉蓄娱呛妮窘构哲金撰冬烈驼京削鬼簇胖苯路支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Diagnosis1.Symptom-free:Gene29DiagnosisDiagnosisprocedure:1.X-rayfilm(-)andsputumforcytology(-)FBC(-)followuponceamonth/year.2.X-rayfilm(+)andsputumforcytology(+)FBCtoidentifythecancercelltypeCT,MRItherapy.豫养恭葱鹃喉酿秆逆坏拧视冤酬绣场焰慑转卡禄螟全煤獭隔矮钓拷碑捉溯支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件DiagnosisDiagnosisprocedure:30DiagnosisDiagnosisprocedure:3.X-rayfilm(-)andsputumforcytology(+)rulingoutthetumorofupperrespiratorytractfirstFBC.4X-rayfilm(+)andsputumforcytology(-)FBC(-)lungbiopsy.梨括靶厨殉篮榆殊截叹粳年啡遍酮限乎骏侠抱韶吗武舰揍好粕富杠迂戮哥支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件DiagnosisDiagnosisprocedure:31Differentialdiagnosis1.Solitarynodule:Tuberculoma,BenignTumor2.Cavitation:LungAbscess,Tuberculosis,3.Enlargementofhilarshadow:Hamartoma4.Others:PleuralEffusion,WideningOfMediatinal.撕株吠徘降喂逆针软察拇租儒结撤抄秋估躲哺渺澎掘哭痉虐呼赐欢短碉吉支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Differentialdiagnosis1.Solita32Treatment1.Rresectionbyoperation;2.Radiotherapy;3.Chemotherapy;4.Immunotherapy;5.TraditionalChinesemedicinetherapyetc.Thetherapeuticprincipleoflungcanceriscomprehensive:rescectthetumorasfaraspossiblethencombinewithothertreatments;othertreatmentsfirstthenoperationdependingonthecytologictype,position,sizeandstageofthetumor.蹿枢秘甚晚戒时跨解拣锁意涕兵炮摧盟随枫堕容浪破鞋讶瓷奈砍忘咒陪经支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Treatment1.Rresectionbyopera33TreatmentSCLC:ⅠChemotherapy,operation.ⅡChemotherapy,radiotherapy.NSCLC:

ⅠOperation.ⅡMost:operation→chemotherapySmallparts:radiotherapy.酸勾幂栖旁攻娜稻著倡冕逮毕状退隔患悟顿刹椅渣沽丝演污裙伞品二世莹支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件TreatmentSCLC:酸勾幂栖旁攻娜稻著倡冕逮毕状退隔34TreatmentⅢ:Operation+chemotherapy;radiotherapy+chemotherapy.Ⅳ:chemotherapy+radiotherapy(relievesomesymptoms,suchaspain,dyspnea,obstructionetc).剂蔚屎盗减埂袭毋朽开速海设鉴鳞庞穷甚铺手们间败溉锰俘贞垮茬契值脏支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件TreatmentⅢ:Operation+chemot35ThankYOU杠割旗者抓凭狙借荚送后泄圆氨沁能旁诬燎伯既桶埔娇宜军漏娇轩耘需辰支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件ThankYOU杠割旗者抓凭狙借荚送后泄圆氨沁能旁诬燎伯既36BronchogenicCarcinoma

(LungCancer)Respiratorydepartment萝堆瑟莎苦督远滇馏秤满华旬耍织块原碰豢碗寄瘦畏脏忘绑绝滔晶氏临范支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件BronchogenicCarcinoma

(Lung37DefinitionBronchogeniccarcinomareferstothemalignanttumorwhichgrowsinthebronchus.Originatingfrommucusorglandofbronchus.慌筷说垃稻釜卉举埂积迪傈昆拼史句飞韭噎紫启挺腾稿抬荷汲踌着据食脉支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件DefinitionBronchogeniccarcino38IncidenceandmortalityBronchogeniccarcinomahasincreasedremarkableinincidenceandmortalityduringhalfofthecenturyandhasbecomethemostfrequentvisceralmalignantdiseasesofmen.Themortalityoflungcancerholdthefirstplaceamongallkindscarcinomas.招则箕惟拌拦瘟红杨秘佐魁皆臼瘟颐里闯汤落及勒项避嫡橡腆闸戴匿染监支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件IncidenceandmortalityBroncho39EtiologyThecauseoflungcancerisunknown.Itisbelievedthattherearefollowingrelatedfactors.1.Excessivecigarettesmoking:Smokingindex(BrinkmanIndex)isequaltocigarettesperdaysmokingtime(years).Passivesmokingisalsoacarcinogenfactor.烁鼻柳三铺化箕美榆挪魁疡敌俯博买冷甫按鸥胶纹惜躺奢郑源豌辣壶桃晕支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件EtiologyThecauseoflungcanc40Etiology2.Atmosphericpollution.Itwasfoundthatcarcinogenicfactorisbenzpyrene.3.Occupationalfactors.4Radioactivityintheatmosphere.5.DietsandNutrition.6.Chronicirritation.7.Geneticfactors.着驼鲜歼辰耀干厂想寥凳值盅绅遮澎净烂蒋纱郊遮拒摸创钓诚菊卵枪型屯支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Etiology2.Atmosphericpollutio41PathologyAndClassification1.Accordingtothepositionoftumorarisingfrom,itcanbedividedintotwotypes.Centraltype:Tumorarisesfrommainbronchus,lobarandsegmentalbronchus.Peripheraltype:Tumorarisesbeyondsegmentalbronchus.讯虎迷孪事裹音燎响房斗翟缅做撵茸窿妆攻瑟湘拿微喝纶魁顽荣冲喷葡竹支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件PathologyAndClassification1.42PathologyAndClassification2.Accordingtocytology,itisconvenienttoclassifyintofourkindsoftypes.(1).Squamouscellcarcinoma.(2).Smallcellanaplasticcarcinoma.(3).Largecellanaplasticcarcinoma.(4).Adenocarcinoma(includingalveolarcellcarcinoma).袜朋痈锋锭湃烷咸弥明磊意颗聪捏偶无权媚诺凛修覆泳乍糊唉镰酗眯夺辜支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件PathologyAndClassification2.43PathologyAndClassificationAccordingtothedifferentprinciplesofmanagement,itisdividedintotwotypes.SCLC:smallcelllungcarcinoma.NSCLC:nonsmallcelllungcarcinoma.欧狮典砖焙藐谐玫年扑日汇肝狠裕叉姥迭澎兜潮真妻桔竟琢搓他柱肄吕发支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件PathologyAndClassificationAc44ClinicalfeaturesTherearenosymptomsofearlylungcancerinsomepatients.Symptomscausedbylungcancerarenon-specific:perhapsanaudiblewheezeoraslightcough,symptomsofinfection(fever,purulentsputum),ofobstruction(wheezing,dyspnea),orulcerationofbronchialmucosa(hemoptysis).哥净残算攘旧仍抵盾惠扁溶寻白昭午佐彭互岂腔伍栏角匣妙痹中靛脉锚惟支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件ClinicalfeaturesThereareno45Clinicalfeatures1.Respiratorysymptoms.(1).Cough:(2).Hemoptysis:(3).Dyspnea.:(4).Wheezeorstridor:(5).Chestpain:(6).Fever:琴玲袄猾成茶震缸匈线傍躺症嗽寝就倪讽羞刻酌挖玫苹尿臭吉尺英烃涉纳支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Clinicalfeatures1.Respiratory46Clinicalfeatures2.Symptomscausedbythenearorgansortissueinvolvedbytumor.(1).Dysphagia.(2).Hoarseness.(3).Pleuraleffusion

duetoinvasionofthepleura.藏购势委缚受藩真燎变莆肚茄噪涨泄揖鹏纸痊厨塔潦渺昌哦天易溜睡谬鸽支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Clinicalfeatures2.Symptomsca47ClinicalFeatures(4).Horner’ssyndrome.Itiscausedbyinvadingthecervicalsympatheticgangliaontheinvolvedsidethepupilissmallptosisoftheupeyelids,retractionoftheeyeballandnosweatoftheface.(5)Cardiaceffusion颧部矩脐蔑寄恨肺苍绽荒辽早杉滨林职舌喇嚏铡渺洗昆清慕北椎邵蕾趾拓支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件ClinicalFeatures(4).Horner’s48Clinicalfetures(6).Superiorvenacavalsyndrome.Duetoobstructionofthesuperiorvenacaval,thepatientmayhavenoticedthathiscollaristight,theneckisenlargedandthejugularveinandtheveinsofanteriorchestwallaredistensionandedemaoftheface.3.Symptomscausedbymetastasis.liver,skeleton,brain,supraclaviclelymphnodes.闷悟纽萎霄绍邪之鲍望邑痞曼庐忍色腆氓授骸钙岭抖匣矣疵汗睁雁雷熔睦支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Clinicalfetures(6).Superiorv49Clinicalfetures4.Paraneoplasticsyndrome.Becausetumorcellcansecreteectopichormone，antigenorenzymethepatientswithLungCancersometimesmayhavesomeparaneoplasticsyndromeIncluding:

(1)Collagentissuedisordersuchasfingerclubbing,hypertrophicpulmonrayosteoarthropathy。盒征束萌忆退堕佣繁哗交沂兆耕膏控营胚获萨测靡奈围斜渴缴座晌专萄覆支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Clinicalfetures4.Paraneoplast50Clinicalfeatures(2)EndocrinedisordersincludingCushing’ssyndrome,syndromeofinappropriateantiduretichormonesecretion(SIADHS),(3)Neuropathicormyopathicdisordersincludingpolyneuritis,cerebellardegeneration,mentalabnormalitisetc

(4)others.蒋匹苟绽屏陛侠仗旬丹畸顾从绊右赣镁嘎糟胸攻隐懒妇蒲鹤勘悦袁浙脯楼支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Clinicalfeatures(2)Endocrine51RadiographicFindingsTheappearanceonthex-rayfilmdependsontheposition,sizeandstageofthetumor1.Peripheraltype:Itmaybevarioussuchasinfiltrativeornodular,

lobulatedorumbilicussign,linerprotrusionsfromtheshadowintothesurroundinglung,cavitationwhichisofteneccentricirregularintheinnerwallowingtothenecrosisoftheneoplasm.滴短抵片荚戏撤辫尖好很毒里陵潍揩穷吟风俘汁猴窟秽潮垦要舷拣布甸境支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件RadiographicFindingsTheappea52RadiographicFindings2

Centraltype(1)Directappearance:Unilateralenlargementofthehilarshadowduetothetumoritselforenlargedlymphnodes.(2)Indirectappearance:Includinglocalemphysema;obstructivepneumoniaeitherlobalorsegmental;obstractiveatalectasis(collapse)lobeorsegment.夺使楷谱幕拉究甄畦特万刮泵嚷缩驯夕殊阿见软柏宿叠跃湍查录帘浮牡淤支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件RadiographicFindings2Central53AdvantageofCT:(1)Somesmalllesion,lesionbehindofcardiacorbloodvessel,andpathologylocatedinapicaloflungcanbefoundbyCTwhichcan’tbefoundbychestx-ray.(2)LymphnodesalonghilarormediastinacanbefoundbyCT.炼窘识陀骆昨肄信冠撩短础敲猴霞僚郧端柬结撇岳险岭绢析窝聋戳碳嘱桶支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件AdvantageofCT:(1)Somesmall54

Fig1Atelectasis,Rightupperlobe彼并陌庄披宵唤还侄估仿着刃刊骇号围馏丸诚运垛哨曝鹰噎前绵螺愧橡油支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig1Atelectasis,Rightupper55

Fig3MassWithFuzzy,RightUpperLObe饲范仪拇垫梨芳晓针憾翻汹情扩京台凄暗揽吞倪梆顽帽移昌七辉茸施吧绚支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig3MassWithFuzzy,Rig56

Fig4MassInrightLobe,Lateralportion袄费恢勤岔桃蝶绎欢果版孽克蕊塑漏宣腥汽蛹兴澡骤儡填祥肤盎谢殿甄丈支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig4MassInrightLobe,Late57

Fig5CavitatingBronchialCarcinoma节贪邓豪靳抵需哲饼瘩厌赠沼然学涧南懒补煤铺粮退娄较宵扫沁惕纲妖暮支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig5CavitatingBronchial58Examinationofsputum

Cytologicexaminationofbronchialsecretions(orsputum)mayrevealexfoliatedmalignantcellsrecognizabletothepathologistwhoisspeciallytrainedforsuchwork.Thesputummusttobefresh,sendontime,repeat(4-6times)..杯烹汀蔓匪共再擞淆星说惯导哈摸字芭肿咱犬古件攀衙愈膜槛蓬泽仕翁虏支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件ExaminationofsputumCytologi59BronchoscopeBronchoscopemayverifytheexistenceoftumor,ofCentraltype,andcytologicdiagnosisoflungcancershouldbeobtainedthoughFBC.Blindbiopsymaybehelptothediagnosisofthetumorbeyondtherangeofbronchoscopevision回咨昧橙昏淆抨福胀曼庞惹撞晋长踢凌贝泣虎土散淌懒碘鞠灵社肿媒碍挤支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件BronchoscopeBronchoscopemayv60Fig1NormalTracheaFig2NormalCarina坯项外减略讹递伺燕江颊肥杆行绵皆绞奢脱漂堤闽障钒挂片龙作屠燃禹侩支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig1NormalTracheaFig2No61Fig3SquamousCellCarcinoma,TracheaFig4AdenocarcinomaLeftLingularBronchus汾冕哎删幢醉埠你狠狐吹雌逻郧曰豢层炭淄恫臃案汁蕴婿狈派庶锚孤捣李支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig3SquamousCellFig4Aden62Fig5AdenocarcinomaRightTruncalIntermedusFig6ExtrinsicPressureTrachea余辛瞥惕猫丑蛤量褪渠攻宪卞氧红曹殉净阶榆泛屯疥乌树肉嗜邱颖硷卷尼支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件Fig5AdenocarcinomaFig6Ext63LungBiopsy1.Biopsywithfiberopticbronchoscope;2.TransthoracicneddlebiopsywithCTdirectedorBtypeultrasonic;3.Biopsywiththoracoscopy;4.Biopsywithmedistinoscopy;5.Exploratorythoracotomy.违矽般蛙捣仇美依避湾密婉责灶婆莉仆揖矣啄眯物姥搏矢拱獭赚荐氨硝茶支气管癌（肺癌）-英文课件支气管癌（肺癌）-英文课件LungBiopsy1.Biopsywithfiber64Diagnosis1.Symptom-free:Generalinvestigationofhighriskgroup(male,mornthan40yearsold,cigaretteconsumption20/perday).Takingax-rayfilmandexaminingsputumforcancercelleveryhalfyearEarlystageofthebronchogeniccarcinomaReferstothetumorisstilllocatedatthebronchus,noinvadethehilarlymphnodes,pleuraaswellasdistantmetastases,itsdiameterisoften<3cm.俱利民盗邦群辉阿朋