肺结核合并肺癌的CT表现

CT differential diagnosis and imaging findings of pulmonary tuberculosis with lung cancer

目的:探讨肺结核合并肺癌的CT影像特征,提高认识及诊断水平。方法:回顾性分析57例肺结核合并肺癌患者的CT影像资料,总结影像特征;57例均行CT平扫和增强检查,均经手术、痰检、纤支镜或穿刺病理证实。结果:57例肺结核合并肺癌患者中,男54例(94.7%)。病理类型为腺癌28例,鳞癌23例,小细胞癌4例,大细胞癌2例;中央型肺癌11例,周围型肺癌46例,空洞及囊腔类肺癌10例。53例患者先出现肺结核后出现肺癌;活动性肺结核合并肺癌43例,稳定结核合并肺癌14例。结论:肺结核合并肺癌的临床表现无特异性,影像学表现复杂多样,易误诊及漏诊,对影像资料的动态追踪尤为重要,CT在诊断中有一定优势。

Objective:To analyze and evaluate CT findings of pulmonary tuberculosis with lung cancer and to improve the accuracy of diagnosis in pulmonary tuberculosis with lung cancer.Methods:All patients were performed on CT non-enhanced scan and enhanced CT scan.All acquired data were measured and analyzed.The CT findings were concluded.All cases were confirmed by pathology,sputum examination.Results:Pulmonary tuberculosis with lung cancer showed the following characteristics:the proportion of male patients in this group was 94.7%.The pathological types of adenocarcinoma,squamous cell carcinoma,small cell carcinoma and large cell carcinoma were 28 cases,23 cases,4 cases and 2 cases respectively.There were 11 cases of central lung cancer,46 cases of peripheral lung cancer and 10 cases of cavity and cystic lung cancer.53 patients in this group had tuberculosis first and then lung cancer.There were 43 cases of active tuberculosis with lung cancer,and 14 cases of stable tuberculosis with lung cancer.Conclusion:Tuberculosis with lung cancer in clinical manifestations and imaging has its complexity and is liable to be misdiagnosed and missed.In follow-up it is particularly important to have dynamic tracking of image data.CT has its advantage in the imaging diagnosis of tuberculosis with lung cancer.