肺炎型肺癌的影像学特征(附18例分析)

Analysis of pneumonic-type bronchioloalveolar carcinoma

目的:探索肺炎型肺癌的影像学特征,以进一步提高对肺炎型肺癌的认识。方法:收集了18例经病理学证实的炎症型肺泡细胞癌,回顾性分析其病灶分布的范围、大小、部位及其影像特征并对其诊断要点进行评价。结果:18例肺炎型肺癌影像学表现两肺多发性分布7例,叶性分布8例,段性分布3例,所有病例均有实变存在,外周分布的15例,伴有不规则小结节的为8例,空气支气管征的11例,叶间裂向外突出的4例,实变影不均匀分布7例,不规则小囊腔6例,CT血管征2例。结论:肺炎型肺癌表现为典型的外周分布,空气支气管征、不规则小结节、叶间裂外突、多发小囊腔样改变等,但与感染性肺炎很难区分。对抗炎治疗反应不好的肺炎应警惕炎型肺癌可能,进行活检诊断。

Objective： To investigate the imaging appearance of pneumonic-type bronchioloalveolar carcinoma（BAC） ,and to further reveal the characteristics of this disease. Methods： Imaging features of 18 cases with pneumonic-type BAC proven pathologically were retrospectively analysed for scope, size,location and some signs for diagnosis. Results： Both sides multilobar consolidations occurred in 7 cases, lobar consolidations in 8 cases, and segment consolidation in 3 cases . The consolidation and ill-defining diffuse nodule appeared in 8 cases, air bronchogram in 11 cases, bulging of the interlobar fissure in 4 cases,heterogeneous consolidation in 7 cases, cystic airspaces in 6 cases, and the CT angiogram sign in 2 cases, the consolidation were peripherally distributed in 15 out of 18 cases. Conclusion： Imaging finding of pneumonic-type bronchioloalveolar carcinoma shows a peripheral consolidation, air bronchogram, bulging of the interlobar fissure, CT angiogram,cystic airspaces and so on. It is difficult to differentiate pneumonictype BAC from infectious pneumonia. Therefore, biopsy is often necessary.