罕见的肺错构瘤

Unusual Pulmonary Hamartoma

目的：评估少见肺错构瘤的影像表现，探讨误诊原因。材料与方法：回顾分析１００例手术病理证实的肺错构瘤中１７例大小、部位特殊者的影像表现。均有正、侧位胸片及病灶体层，８例有ＣＴ扫描（ＨＲＣＴ２例）。结果：大错构瘤１１例，长径４～１１ｃｍ，均为边界清楚、无毛刺或卫星病灶的肺内肿块，浅分叶７例，钙化７例，ＣＴ扫描３例检出脂肪２例。支气管腔内型错构瘤６例，有阻塞性肺改变４例，单纯肺内肿块２例。ＣＴ扫描５例，３例检出钙化和／或脂肪，４例不张肺中均有支气管通气征。误诊为肺癌共７例，原因为忽略瘤内钙化和／或脂肪密度及不正确的ＣＴ窗技术。结论：应着重观察肿块内有无脂肪或钙化。

Objective: To study the imaging manifestations of the uncommon pulmonary hamartoma.Materials and Methods:Seventeen unusual hamartomas out of 100 surgical proven cases were retrospectively analysed. All had AP, lateral chest films and linear tomographs, 8 cases had CT (HRCT 2 cases).Results:Large (≥4cm) pulmonary hamartoma: 11 cases with diameter 4～11cm, all were well demarcated masses without spiculation or satellite lesions in the parenchyma, mildly lobulated in 7 cases, calcification were found in 7 of 11 cases, fatty density were detected by CT in 2 of 3 cases. Endobronchial hamartoma 6 cases, the bronchus were occluded with obstructive atelectasis in 4 cases, 2 cases appeared as parenchymal masses. 5 cases had CT which detected calcification and/or fat in 3 cases, and air bronchogram in all of the 4 cases with obstructive atelectasis. 7 cases were misdiagnosed as lung cancer, due to disregard fat and/or calcification inside the tumor or by using improper CT window.Conclusion: Full attention must be paid to see if any fat and/or calcification inside the tumor. HRCT is very helpful for revealing the internal structure of the mass and the relationship between tumor and bronchus.