摘要
目的探讨肺炎型肺癌的影像学特征,提高认识。方法回顾性分析9例经病理证实的肺炎型肺癌的临床资料及其胸部X光、CT表现。结果 9例肺炎型肺癌初诊时8例诊断为肺炎,1例X光胸片疑似肺结核时CT诊断为肺炎。9例均抗感染治疗无效后,取组织做病理学检查确诊为肺癌,其中腺癌8例,鳞癌1例。9例肺癌表现为:中下肺叶8例,上叶1例;局灶单发8例,多发1例;右肺7例,左肺1例,双肺多发1例;9例均靠近肺野外围,呈节段性或大叶性实变,边界模糊,呈毛玻璃样变,病灶内见空气支气管征3例,空泡征2例;胸部X光片均表现为淡薄片状阴影,无明确边界;9例均抗感染治疗无效,其中3例进展。结论肺炎型肺癌的临床表现与一般肺炎相似,影像学表现有一定的特异性,但和一般肺炎的鉴别仍较困难;对中年以上人群,X线胸片发现节段性或大叶性肺炎或肺不张时,应行CT检查,影像医师在诊断肺炎的同时,不应排除肺炎型肺癌的诊断可能,临床医师在积极抗感染治疗后应短期跟踪复查,对病灶吸收不明显的患者,应及时行病理学检查。
Objective To investigate the imaging characteristics of pneumonic-type carcinoma of lung（PTCL）. Methods 9 cases of PTCL with pathological diagnosis were analyzed retrospectively. The clinical data and the image features of PTCL were summarized. Reessuullttss All these 9 cases of PTLC, 8 cases were diagnosed pneumonia, 1 case suspected pulmonary tuberculosis by X-ray examination and pneumonia by CT. These 9 cases were treatment futility of anti-infective and accepted tissue biopsy. The pathological examination were lung carcinoma, including 8 adenocarcinoma and 1 squamous-celled carcinoma. The image features of PTCL including 8 cases in middle and inferior lobe,1 superior lobe;8 single and 1multiple;7 right lung,1 left lung and 1 double lung; all the focus locate in periphery of lung, showed as segmental or lobar consolidations, with unclear border and ground-glass opacities;3 cases were found air bronchogram and 2 vacuole sign. All the focus showed as light patched shadow and obscurity boundary in X-ray examination. All these 9 cases＇ PTCL were treatment futility of anti-infective and 3cases progressing. Conclusions The clinical manifestation of PTCL is similar with common pneumonia, and the image features have some specificity, but it＇s hard to differentiate with common pneumonia. So the patients above middle-aged should accept CT examination, if focus as segmental or lobar consolidations and atelectasis are found in chest X-ray examination. The diagnose of pneumonia could be definitive, but PTCL should not be elimination. The patients should be short-term followed up and reexamination after antiinfective treatment, pathology examination should be proceeded if the effect is not so better.
出处
《中国CT和MRI杂志》
2014年第9期75-77,共3页
Chinese Journal of CT and MRI
关键词
肺炎型肺癌
肺炎
CT
Pneumonic-type Carcinoma of Lung
Pneumonia
CT
