成人肺先天性囊性腺瘤样畸形

Congenital cystic adenomatoid malformation of lung in adult

目的探讨成人肺先天性囊性腺瘤样畸形(CCAM)的影像学表现,提高影像诊断水平。方法对5例经手术病理证实的CCAM的影像学资料进行随访和回顾性分析,5例均有X线胸片,其中2例行胸部CT扫描。结果5例中3例胸部X线表现为肺内薄壁低密度透亮区,部分囊内有液平面。1例为下肺近胸膜处蜂窝状、网格状、囊状空腔,周围可见毛刺征,1例为相邻数个类圆形空腔。胸部CT见1例右肺中叶外侧段椭圆形透亮区,壁薄且光整,左肺上叶尖后段薄壁囊状透亮区,且与胸膜相连。1例双下肺基底段近胸膜处蜂窝状薄壁空腔,右下叶基底段肿块影,可见毛刺征。结论CCAM的影像学表现为胸膜下的囊性或囊实性病变,同时有伴发肺癌的危险性。

Objective To investigate of the radiological manifestations in congenital cystic adenomatoid malformation （CCAM） of lung in adult and to improve the diagnostic accuracy of CCAM of lung in adult. Methods Five cases with pathologically proved CCAM of lung in adult were retrospectively analyzed. Chest X-ray was available in 5 cases and chest CT was performed in 2 cases. Results On plain chest radiography, thin wall air cystic lesions with air-fluid level were detected in 3 cases. Honeycomb like small cystic lesion was detected in 1 case. Multiple round cystic lesions were found in 1 case, CT scan of the chest demonstrated a round thin wall air cystic lesion in the lateral segment of right lung＇s middle lobe, and a thin wall air cystic lesion with the wall merged into the shadow of chest wall in the left apicoposterior segment in one case, Small cystic lesions just like honeycomb were found in bilateral basal segments of the inferior lobes, with a 0.8-1. 0 cm sized round mass revealed in the right lung＇s inferior lobe basal segment, and the mass was spiculated in another case. Conclusion The imaging signs of CCAM of lung in adult is cyst or cyst-solid and at the risk of developing carcinoma,