肺癌向脑部扩散

W.I.B. Onuigbo
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引用次数: 10

摘要

脑淋巴系统的存在是有争议的。因此,目前的观点是肺癌通过动脉转移到这个器官。从理论上讲,动脉肿瘤栓塞的分散应该导致沉积在大脑两侧的均匀分布。类似地,淋巴性播散到大脑会导致同侧沉积物的优势。本文分析了250例肺癌脑转移病例。本系列病例为全部或主要转移于大脑或小脑半球的病例。发现转移趋势是同侧的,而不是均匀的。结果具有统计学意义,143例完全或主要为同侧生长,107例为对侧生长。从文献中收集的55例病例也表现出统计学上显著的同侧优势。本文附5例说明这种转移趋势的病例。从文献中引证了确凿的证据:1。膈上肿瘤比膈下肿瘤更容易转移到脑部。相对较近的小脑是转移倾向的部位。多发宏观转移的发生率仅为单发转移的两倍。转移性脑肿瘤的组织病理学指出了血管周围和蛛网膜下腔的重要性。结论是,一个统一的理论转移到淋巴结和器官,如脑和肾上腺是可能的,并可能是根本的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The spread of lung cancer to the brain

The existence of a lymphatic drainage for the brain is disputed. In consequence, the current view is that lung cancer metastasises to this organ via the arteries.

Theoretically, arterial scattering of tumour emboli should result in an even distribution of deposits on either side of the brain. Similarly, lymphogenous dissemination to the brain would lead to ipsilateral preponderance of deposits.

Two hundred and fifty cases of brain metastases following lung cancer are analysed. The cases in the series are those in which metastases occurred either wholly or mainly in one cerebral or cerebellar hemisphere.

It is found that the metastatic trend is ipsilateral rather than even. A statistically significant result was obtained, for there were 143 growths which were wholly or mainly ipsilateral as against 107 contralateral ones.

Fifty-five cases collected from the literature also exhibited a statistically significant ipsilateral preponderance. Five cases illustrative of this trend in metastasis are appended.

Corroborative evidence is adduced from the literature:

  • 1.

    Supradiaphragmatic tumours metastasise to the brain more often than infradiaphragmatic growths.

  • 2.

    The relatively nearer cerebellum is a site of metastatic predilection.

  • 3.

    Multiple macroscopic metastases occur only twice as often as the solitary.

  • 4.

    The histopathology of metastatic brain tumours points to the importance of perivascular and subarachnoid spaces.

It is concluded that a unitary theory of metastasis to both the lymph nodes and organs like the brain and adrenal is possible and may be of fundamental importance.

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