Analysis of the Internal Structure of Peripheral Pulmonary Lesions Using Endobronchial Ultrasonography: Heterogeneous Pattern

The density of cancer cells was higher, and the volume of air remaining in the alveoli was smaller in type IIb lesions than in type IIa lesions (ie, well-differentiated adenocarcinoma). The margins were irregular because the lesions grew without any relationship to existing structures. The type IIb group included one case of moderately differentiated adenocarcinoma and two cases of malignant lymphoma, in addition to the eight cases of well-differentiated adenocarcinoma.
Type III: Heterogeneous Pattern
Type Ilia, Heterogeneous Pattern With Hypere-choic Dots and Short Lines: Fifty-three lesions (42.7%) were classified as type IIIa (Fig 3). The majority of cases (30) were moderately differentiated adenocarcinomas that had grown with a relatively high cell density and had formed a mass website buy antibiotics online. No blood vessels were seen within the lesion by EBUS. Areas of mottling and linear hyperechoic areas were irregularly distributed within the lesion, corresponding to compressed or stenotic bronchi or alveolar air. The internal echoes were heterogeneous, markedly attenuated sound-wave transmissions, so only areas about 6 to 8 mm from the probe could be visualized clearly. Because the lesions spread in a random manner, without extension along lung structures, the margins of the lesions often were rounded. The type IIIa group included three cases of well-differentiated adenocarcinoma, four cases of poorly differentiated adenocarcinoma, nine cases of moderately differentiated squamous cell carcinoma, six cases of poorly differentiated squamous cell carcinoma, and one case of organizing pneumonia, in addition to the 30 cases of moderately differentiated adenocarcinoma. Moderately differentiated squamous cell carcinomas presented numerous echo-free areas that corresponded to areas of necrosis within the tumor, which is characteristic of squamous cell carcinoma.