169.Lymphangitic carcinomatosis（癌性淋巴管炎）

每天朗读一段医学影像学英语文章

Lymphangitic spread of tumor in the lung is a relatively rare metastatic pattern, typically to the result of adenocarcinomas. 

肺癌沿淋巴管播散转移相对少见，典型见于腺癌。

The tumor cells are deposited in the lung periphery by hematogenous dissemination and then, rather than forming the typical nodule, infiltrate the pulmonary lymphatics and interlobular septa growing back toward the hila, producing thickening of the interlobular septa and peribronchovascular interstitium. 

肿瘤细胞通过血行播散积于肺外周，因此不会形成典型的肺结节，而是浸润肺淋巴管和小叶间隔，向肺门蔓延，导致小叶间隔和支气管血管周围间质增厚。

Occasionally, the spread of lymphoma can also occur along pulmonary lymphatics, extending peripherally from a central lesion. Although pulmonary sarcoidosis may mimic this radiographic appearance, the patient’s clinical presentation and past medical history should allow for confident distinction of the two. 

淋巴瘤偶尔也会发生在肺淋巴管，从病灶中央向周围浸润。虽然肺结节病的影像表现与其相似，但临床表现和病史有助于鉴别。

In particular, the presence of unilateral disease or pleural effusion strongly favors lymphangitic carcinoma . When in doubt the diagnosis can be confirmed by bronchoscopy with trans-bronchial biopsy. It is important to remember that lung cancer and treatment of lung cancer with radiation therapy may lead to central venous and lymphatic obstruction that may result in interstitial opacities . This local phenomenon should not be confused with lymphangitic carcinomatosis and the inappropriate use of this term can have grave implications with the misclassification of staging leading to inappropriate therapy.

特别是单侧病变和胸腔积液高度提示淋巴管转移癌。可通过支气管镜活检确诊。要注意肺癌和经放疗治疗的肺癌，可导致中央静脉和淋巴管阻塞，形成肺间质致密影。这种局部的征象不要与淋巴管转移癌相混淆。滥用该术语会导致错误的分期从而采取不恰当的治疗手段。

以上主题选自心胸影像病例汇

Notes:

1. lymphangitic adj. 淋巴管炎的

2. carcinomatosis [ˌkɑ:səˌnoʊmə'toʊsɪs] n. 癌扩散

3. metastatic [ˌmetə'stætɪk] adj. 转移性的

4. adenocarcinoma [ˌædnoʊˌkɑ:sə'noʊmə] n. 腺癌

5. periphery [pəˈrɪfəri] n. 外围; 边缘

6. hematogenous [ˌhemə'tɒdʒənəs] adj.造血的，血行的

7. dissemination [dɪˌsɛməˈneʃən] n. 播散

8. sarcoidosis [ˌsɑ:kɔɪ'doʊsɪs] n. 结节病

9. pleural ['plʊərə] adj. 胸腔; 胸膜的

10. bronchoscopy [b'rɒntʃəskəpɪ] n. 支气管镜

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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