Clinic misdiagnosis and imaging analysis of superior sulcus tumors of pulmonary

WANG Chang-bin; LI Min

Abstract：Objective To analyze misdiagnosis reason and imaging characteristics of superior sulcus tumors of pulmonary so as to improve the diagnostic accuracy .Methods The clinical symptoms ,imaging findings and misdiagnosis reasons of 19 cases of superior sulcus tumors of pulmonary were investigated retrospectively .Results In the 19 patients with superi‐or sulcus tumors of pulmonary ,medical history were about 2 .6~9 .7 months .The earliest clinical symptoms included pain in shoulder and back (n=17 cases) ,neck pain (n=15 cases) ,upper extremity pain (n=14 cases) ,hand radiated pain (n=11 cases) ,and Horner’ syndrome (n=6 cases) .According to VAS method ,the pain degrees were 4~7 scores .16 out of the 19 cases were misdiagnosed :9 patients were diagnosed as periarthritis of shoulder ,4 as cervical spondylosis and 3 as neck‐shoulder syndrome .Routinely ,chest X‐ray film was negative in 5 cases .But anterior arch radiography showed soft tissue density in lung apex .CT imaging showed soft tissue density shadows at the apical segments of the lungs in all cases . Tumors invaded the ribs in 17 patients and the T1 or T2 vertebral bodies in 15 patients .11 subclavian arteries and 13 sub‐clavian veins were encased by the tumors .10 patients suffered from tumors invading T 1 vertebral body and the first ribs .7 tumors encased the subclavian artery and the subclavian vein simultaneously .Conclusion Painful shoulder and back were the common initial symptoms of superior sulcus tumors of pulmonary ,which is often identified in intermediate and ad‐vanced stage and misdiagnosed .Anterior arch radiography and multi‐slice CT with excellent post‐processing techniques may play an important role in the clinical diagnosis and therapy of superior sulcus tumors of pulmonary .