【連載】肺癌画像診断の“勘”どころ〜最終診断への道しるべ■CT画像診断のコツ　肺野型肺癌：非小細胞肺癌（腺癌）ー肺腺癌のCT画像：病理学的浸潤巣に基づいたCT所見ー■梁川雅弘，ほか |

【連載】肺癌画像診断の“勘”どころ〜最終診断への道しるべ

企画：酒井文和

　肺癌の診断における画像診断の役割は，その検出，肺癌かその他の疾患かの鑑別診断，臨床病期分類などさまざまな役割がある。現在では，単純X線撮影の主な役割は異常陰影の検出，CTは肺癌か他疾患かの鑑別診断，臨床病期分類の診断などが挙げられる。またMR，FDG-PETが併用されることも少なくない。これらの多岐にわたる画像診断をいかにうまく組み合わせて最終診断にいたるか，また主な画像所見とどのような画像所見が鑑別上重要か？　鑑別診断のコツなどを解説いただく。肺癌集団検診の動向，合理的運用方法，また検診で発見された異常の合理的扱い方法についても解説いただく。

CT画像診断のコツ　肺野型肺癌：非小細胞肺癌（腺癌）ー肺腺癌のCT画像：病理学的浸潤巣に基づいたCT所見

梁川雅弘，本多　修，富山憲幸*

*大阪大学大学院医学系研究科放射線統合医学講座放射線医学教室（〒565-0871　大阪府吹田市山田丘2-2）

CT imaging of lung adenocarcinoma: CT findings based on pathological invasiveness

Masahiro Yanagawa*, Osamu Honda*, Noriyuki Tomiyama*

*Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka

Keywords：CT，肺癌，腺癌，浸潤径，病理学的浸潤／computed tomography，lung cancer，adenocarcinoma，invasiveness size，pathologic invasiveness

呼吸臨床 2019年3巻4号　論文No.e00079
Jpn Open J Respir Med 2019 Vol.3 No.4 Article No.e00079

DOI: 10.24557/kokyurinsho.3.e00079

掲載日：2019年4月8日

©️Masahiro Yanagawa, et al. 本論文の複製権，翻訳権，上映権，譲渡権，貸与権，公衆送信権（送信可能化権を含む）は弊社に帰属し，それらの利用ならびに許諾等の管理は弊社が行います。

要旨

　肺腺癌は，非小細胞肺癌の中で最も多い組織型の肺野型肺癌ある。2011年より浸潤という概念に基づき，上皮内腺癌，微少浸潤性腺癌，浸潤性腺癌，特殊型腺癌に細分化されるようになり，予後や遺伝的背景に沿った集学的な分類がなされるようになった。また，TNM分類第8版においては，T分類を決定するためにCT上での浸潤径の計測が重要視されている。したがって，肺腺癌のCT画像所見を十分に理解しておくことは重要であり，本稿では画像所見の他，病理学的浸潤巣にも焦点を当てながら，肺腺癌のCT画像診断について解説する。

文献

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