転移性肺腫瘍のX線学的考察

特に肺腺癌の肺転移X線像について

抄録

The radiograms of 391 cases of metastatic lung tumors were studied in order to find out the characteristics of the metastatic tumors with special reference to intrapulmonary dissemination of the primary pulmonary adenocarcinoma. In all of these cases, the sites of the original tumors and the histological features of the metastasized tumors were already known. The results obtained were as follows.
1) Characteristics of metastatic lung tumors were radiographically studied according to the sites of the original tumors. In 82 cases of the metastatic tumors, the time needed for doubling the size of the radiographic shadow was measured and studied.
2) It was the bilaterally disseminated shadows that characterized the intrapulmonary dissemination of the pulmonary adenocarcinoma. In some cases, the dissemination was detected at early stages. It was revealed that the increased lung markings were the first signs of the dissemination. As time elapsed, fine nodular shadows appeared. These shadows subsequently became larger and finally fused into ill-defined large conglomerated shadows.
3) It was radiographically possible to distinguish the dissemination of the pulmonary adenocarcinoma from that of the pulmonary squamous cell carcinoma.
4) The dissemination of the well-differentiated adenocarcinoma exhibited more typical diffuse-shadows as compared with that of the moderately-or poorly-differentiated adenocarcinoma. The growth of the tumor was slower in the former than in the latter.
5) In 6 out of 67 cases, it was suspected that the dissemination took place transbronchially rather than hematugenously. But this was not proved by the smear method applied to the lobe of extraprimary-lesion.