修.翻译七年制)呼吸影像纵隔肿瘤.2.pptVIP

呼吸系统影像诊断学Imaging diagnostics of the respiratory system郑州大学第一附属医院放射科the first affiliated hospital radiology departmentof Zhengzhou University张焱Zhang Yan 呼吸系统疾病 Disease of the Respiratory system 五.纵隔原发肿瘤（mediastinal tumor） 指原发于纵隔的肿瘤 primary mediastinal tumor 原发性纵隔肿瘤繁多 The tumor primary in mediastinum,which are various 常见的纵隔肿瘤： Common primary mediastinum tumor 神经源性肿瘤Neurogenic tumor 淋巴瘤Lymphoma 畸胎瘤Teratoma 胸腺瘤Thymoma 胸内甲状腺等intrathoracic thyroid 临床症状： clinlcal symptom 胸骨后不适及隐痛 retrosternal malaise and vague pain 与肿瘤的大小、部位、良恶性有关 related to the size, position and nature(benign or malignant) 纵隔肿瘤所引起的症状以压迫症状为主 该类症状的出现，对肿瘤的定位及定性亦有帮助 cardinal symptom:pressure symptom is the cardinal symptom of mediastinal tumor Which has helps to localization and qualitative analysis of the tumor 压迫邻近组织器官：press adjacent tissue and organa 上腔静脉综合征 superior vena cava syndrome ; SVCS 声嘶（喉反神经）trachyphonia Horner综合征（交感神经）Horners syndrome (sympathetic nerve) 心率慢（迷走神经）slow heart rate (vagus nerve ) 吞咽困难（食道）hard to swallow (esophagus) 心脏受压oppression of heart 食管受压oppression of esophagus 气管受压等oppression of tracheal （一）胸腺瘤（Thymoma）： 较常见usual 约30%患者有重症肌无力myasthenia gravis 良性：benign 有完整包膜integrated integument ，可有囊变cystic change 侵袭性（恶性）：invasion (malignancy) 向邻近组织局部侵犯local invasion of adjacent tissue 常发生胸膜种植转移membrana pleuralisimplantation metastasis is usual很少有血行或淋巴转移hematogenous metastasis or lymphatic metastasis is singularly 影像表现：imaging 1.多位于前中纵隔偏上antemedial mediastina ，多向一侧突出extrude to one side 2.肿瘤为圆、椭圆或梭形致密影round , ovalor fusiform high density lesion ，偶呈片状lamellar lesion 边界清楚the border is clear (well-defined) 3.恶性者呈分叶状therioma is sublobe ，部分边界毛糙part border Of them is coarse ，邻近胸膜受侵the adjacent pleura was invaded 4.瘤内可有斑片状钙化patchy calcification in the tumor 5.囊变者可有蛋壳状钙化 egg shell calcification with cystic change （二）畸胎类肿瘤（Teratoma） 系原始胚胎组织残留物形成的先天性肿瘤 congenital tumor which grow up by residual primordial germ tissue 分为囊性cystic（皮样囊肿dermoid cyst）和实性畸