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A woman from Hangzhou, 58 years old, came to the multidisciplinary joint clinic of Professor Ma Shenglin of Hangzhou Cancer Hospital Affiliated to Zhejiang University School of Medicine a few days ago to see pulmonary nodule.
Let's take a look at her chest CT image:
The beginning of the lesion is not very obvious, only slightly different
The imaging features of this layer are more obvious: orange arrows indicate blood vessels entering the lesions; brick arrows indicate shallow lobulation signs on the surface of the lesions; red arrows indicate that the outline of the lesion and the border of the tumor and lung are clear, and the density is slightly uneve.
The above picture shows that the blood vessels pass through the edge of the lesion, and the overall outline is clear
The above picture is already the edge of the lesion, only a little shadow of the light ground glass
Imaging Impressions and Clinical Thinking:
Such a left upper lobe ground-glass nodule, which has not been absorbed and improved after follow-up, has the following general characteristics:persistent;pure ground-glass density, but slightly uneven density;vascular access and blood vessels passing through the lesion; .
Final result:
After careful consideration, a certain A decided to undergo surger.
The red arrow points to the lesion; the green arrow points to the positioning medical glue, the two are very close
The above picture shows the specimen, the blue arrow points to the lesion, the cut surface is slightly gray and white, slightly hard, and the surface is uneven and lobulate.
The pathological diagnosis was minimally invasive adenocarcinom.
think:
I think there have been many cases in clinical practice that look like "pure ground-glass nodules with lower density (when there is no vascular access, they should be lesions consistent with atypical hyperplasia density) + malignant features ( For example: blood vessels enter through or abnormal thickening, lobulation, burrs, et.
: .
