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本文对64例原发性支气管肺癌的系列胸片作回顾性观察,研究其动态。其中阻塞性肺炎26例,17例首次胸片可见肺门浓密或增大。抗炎治疗炎症吸收,但肺门仍保持浓密或增大;炎症进展,肺门改变亦可进展,甚至出现肿块。因此,肺门浓密增大可作为阻塞性肺炎的标志。孤立肺病灶36例,首次胸片病灶≤2cm者,空泡征出现率较高,可作为肺癌早期征象。>2cm者,毛刺征、分叶征及肿瘤至胸膜侧肺野内长线影及模糊影出现率增加,提示有肺癌的可能。>3cm者空泡征消失。胸膜凹陷征的出现与病灶大小不成比例。重点观察了<2cm的病灶,首次胸片以薄片影、小结节或网点影出现后的演变过程。讨论了胸片中如何才能早期发现<2cm肺癌的线索。另外还观察到肺腺癌的早期少见表现,呈大片间质性改变。
In this paper, 64 cases of primary bronchial lung cancer were retrospectively observed and their dynamics were studied. There were 26 cases of obstructive pneumonia and 17 cases of chest X-ray showed thick or enlarged hilar. Anti-inflammatory treatment of inflammatory absorption, but the hilar remains thick or enlarged; inflammation progresses, hilar changes can also progress, and even a lump. Therefore, a thick hilar can be used as a marker of obstructive pneumonia. Isolated lung lesions in 36 cases, the first chest X-ray lesions ≤ 2cm, the higher incidence of vacuolar signs, can be used as early signs of lung cancer. >2cm, the burr sign, leaf markings and tumors to the pleural side of the lungs in the long-term shadow and the incidence of fuzzy shadow increased, suggesting the possibility of lung cancer. The cavitation sign disappears in >3cm. The appearance of pleural recession is not proportional to the size of the lesion. The focus was on lesions <2 cm, and the evolution of the first chest radiograph with thin shadows, small nodules, or dot shadows. Discusses how the early detection of <2cm lung cancer can be found in chest radiographs. In addition, early rare manifestations of lung adenocarcinoma were observed, showing large interstitial changes.