CAJ | 학술논문

背景与目的英国学者Anderson和Pierce于1954年首先报道了表现为囊性病变的肺癌。作为少见的肺癌特殊表现类型，薄壁囊性肺癌在临床中经常被误诊。本研究旨在探讨薄壁空洞性肺癌的临床特点、影像学特点，诊断及治疗。方法自2007年3月-2013年12月，解放军总医院胸外科共收治4,897例原发性肺癌患者，其中24例影像学表现为薄壁空洞型肺癌。我们将影像学上表现为囊性且75%以上囊壁厚度小于4 mm的肺癌定义为薄壁空洞性肺癌。回顾性总结24例病例的临床资料、病理结果及随访情况。结果薄壁空洞型肺癌在我科同期接受手术的肺癌中比例为0.49%（24/4,897）。其中男性19例，女性5例，平均年龄56.5岁。14例无临床症状，于查体时发现。10例有呼吸道症状。24例患者中18例为腺癌（包括原位腺癌及微浸润腺癌），3例鳞癌，1例大细胞癌，1例小细胞癌，1例腺鳞癌。平均随访时间28个月，3例因肺癌死亡，其余21例未见复发。结论薄壁空洞型肺癌是肺癌少见的影像学表现类型，临床中应避免误诊。其具体形成机制并不明确，可能是肺癌形成的某一阶段。薄壁空洞型肺癌如能早期诊断，可获得较好预后。
배경여목적영국학자Anderson화Pierce우1954년수선보도료표현위낭성병변적폐암。작위소견적폐암특수표현류형，박벽낭성폐암재림상중경상피오진。본연구지재탐토박벽공동성폐암적림상특점、영상학특점，진단급치료。방법자2007년3월-2013년12월，해방군총의원흉외과공수치4,897례원발성폐암환자，기중24례영상학표현위박벽공동형폐암。아문장영상학상표현위낭성차75%이상낭벽후도소우4 mm적폐암정의위박벽공동성폐암。회고성총결24례병례적림상자료、병리결과급수방정황。결과박벽공동형폐암재아과동기접수수술적폐암중비례위0.49%（24/4,897）。기중남성19례，녀성5례，평균년령56.5세。14례무림상증상，우사체시발현。10례유호흡도증상。24례환자중18례위선암（포괄원위선암급미침윤선암），3례린암，1례대세포암，1례소세포암，1례선린암。평균수방시간28개월，3례인폐암사망，기여21례미견복발。결론박벽공동형폐암시폐암소견적영상학표현류형，림상중응피면오진。기구체형성궤제병불명학，가능시폐암형성적모일계단。박벽공동형폐암여능조기진단，가획득교호예후。
Background and objective Lung cancer presenting as cystic lesions was ifrst described by Anderson and Pierce in 1954. Lung cancer presenting as cysts is a rare entity in clinical practice. Differential diagnosis is diffcult in the benign-like cyst. hTis study investigated the clinical characteristics, diagnosis and treatment of lung cancer presenting as cysts. Methods We conducted a retrospective analysis of the clinical records of 24 patients who underwent surgery for a primary lung cancer presenting as cysts in our department between 2007 and 2013. We deifned a‘hTin-walled cyst’ as a cavitary lesion with a wall thickness of 4 mm or less along at least 75%of the circumference of the lesion. hTe whole group underwent post-operative follow-up. Results hTe incidence of cystic lung cancer was 0.49%(24/4,897) of surgical cases. hTe subjects’ age ranged from 19 to 77 yr with a median age of 56.5 yr. Ten cases presented with respiratory symptoms while 14 showed abnormal shadows on a chest CT without symptoms. Histological analysis showed that 18 cases were of adenocarcinoma, three of squamous cell carcinoma, one of small cell carcinoma, one of adenosquamous carcinoma and one of large cell carcinoma. hTree patients were dead, and the remaining 21 patients are alive and disease free at the end of follow-up. Conclusion Cystic lung cancer should be kept in mind during the differential diagnosis of focal benign cyst. Cystic lung cancer could achieve a good outcome if early diagnose can be obtained.