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1、會(huì)計(jì)學(xué)1肺癌與肺結(jié)核肺癌與肺結(jié)核第1頁(yè)/共35頁(yè)第2頁(yè)/共35頁(yè)wintralumenal growth pattern- often resulting in distal atelectasis or post-obstructive pneumonitis (a non-infectious process). wthe lowest frequency of distant metastases, spreads to involve local nodes by direct extensionwthe most favorable prognosis wHypertrophic o
2、steoarthropathy 第3頁(yè)/共35頁(yè)第4頁(yè)/共35頁(yè)第5頁(yè)/共35頁(yè)第6頁(yè)/共35頁(yè)第7頁(yè)/共35頁(yè)第8頁(yè)/共35頁(yè)第9頁(yè)/共35頁(yè)T1: A tumor less than or equal to 3 cm in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than the lobar bronchus (i.e., not in the main bronchus).TUMOR第10頁(yè)/共35
3、頁(yè)第11頁(yè)/共35頁(yè)T2: A tumor with any of the following features:i) Larger than 3 cm in largest dimension第12頁(yè)/共35頁(yè)ii) Associated with atelectasis or post-obstructive pneumonitis that extends to the hilar region, but does not involve the entire lung第13頁(yè)/共35頁(yè)iii) Invades the visceral pleura第14頁(yè)/共35頁(yè)T3: A tumo
4、r of any size that directly invades any of the following: the chest wall (including superior sulcus tumors), diaphragm, mediastinal pleura, parietal pericardium; or tumor in the main bronchus less than 2 cm distal to the carina (but without involvement of the carina); or tumor associated with atelec
5、tasis or obstructive pneumonitis of the entire lung.第15頁(yè)/共35頁(yè)第16頁(yè)/共35頁(yè)T4: A tumor of any size that invades any of the following: mediastinum, heart, great vessels, trachea, esophagus, vertebral body, carina; or any tumor with a malignant pleural or pericardial effusion; or with satellite tumor nodul
6、es within the ipsilateral primary-tumor lobe of the lung.第17頁(yè)/共35頁(yè)第18頁(yè)/共35頁(yè) 第19頁(yè)/共35頁(yè)Regional Lymph Node Status (N) N1: Ipsilateral peribronchial or hilar nodal metastases; or intrapulmonary nodes involved by direct extension of the primary tumor. All N1 nodes lie distal to the mediastinal pleural r
7、eflection. 第20頁(yè)/共35頁(yè)N2: Ipsilateral mediastinal and subcarinal lymph nodal metastases. Midline pre-vascular and retrotracheal nodes are considered ipsilateral 5, while nodes to the contralateral side of midline are considered N3 第21頁(yè)/共35頁(yè)N3: Contralateral mediastinal or contralateral hilar nodal met
8、astases; also includes ipsilateral or contralateral scalene or supraclavicular nodes. Other cervical nodes are classified M1 第22頁(yè)/共35頁(yè)Distant Metastasis (M)M0: No distant metastasis M1: Distant metastasis present; or separate tumor nodules in the ipsilateral nonprimary-tumor lobes of the lung. Separ
9、ate tumor nodules in the contralateral lung are considered M1 if they are of the same histologic cell type as the primary lesion. A contralateral lung tumor with a different cell type is considered a synchronous primary lesion and should be staged independently 第23頁(yè)/共35頁(yè)第24頁(yè)/共35頁(yè)原發(fā)肺結(jié)核原發(fā)肺結(jié)核原發(fā)綜合原發(fā)綜合征征第25頁(yè)/共35頁(yè)支氣管淋巴結(jié)結(jié)核支氣管淋巴結(jié)結(jié)核 tuberculosis of bronchial lymph nodes原發(fā)肺結(jié)核原發(fā)肺結(jié)核第26頁(yè)/共35頁(yè)肺浸潤(rùn)及增殖肺浸潤(rùn)及增殖infiltration and proliferation浸潤(rùn)肺結(jié)核浸潤(rùn)肺結(jié)核第27頁(yè)/共35頁(yè)2、TB浸潤(rùn)、空洞及支氣管播散浸潤(rùn)、空洞及支氣管播散infiltrative pulmonary tuberculosis with cavity 浸潤(rùn)肺結(jié)核浸潤(rùn)肺結(jié)核第28頁(yè)/共
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