食管癌并发肺脓肿26例影像分析

The Image Analyses in 26 Cases of Esophageal Carcinoma Complicated with Pulmonary Abscess

目的探讨食管癌并发的肺脓肿临床、影像特点及发病原因。方法回顾性分析了26例食管癌并发的肺脓肿临床、影像学表现。结果本组病例热型76.9%为中低热,23.1%为高热,80.8%咳黏液脓性痰,19.2%咳脓臭痰。均为中晚期食管癌,42.3%有食管穿孔,34.6%有尖角溃疡。肺脓肿与食管癌灶紧密相邻占88.5%,食管穿孔肺瘘占34.6%。肺脓肿表现为肺内大片致密影,边缘模糊不清,其内有空洞,单房空洞占80.8%,内壁光滑占88.5%,有液气平面占80.8%。结论食管癌并发的肺脓肿以继发性居多,影像表现典型,临床表现不典型。

Objective To explore clinical situation, image features and invasion reason of esophageal carcinoma complicated with pulmonary abscess. Methods Clinical manifestation and imaging appearance of 26 cases with esophageal carcinoma complicated with pulmonary abscess were analyzed retrospectively. Results Fever type of all patients： 76.9% had cardiothoracic fever or low-grade fever, 23.1% was hyperpyrexia, 80.8% had cough with blenno-purulence sputum, 19.2% had cough with brom-pus sputum. All the cases were intermediate or advanced stage patients with esophageal carcinoma. 42.3% had perforation of oesophagus, 34.6% had cusp angle ulcer. Pulmonary abscess was tightly close together with lesion of esophagus in 88.5%. Perforation of oesophagus induced pulmonary fistula in 34.6%. Pulmonary abscess appeared large lamellar pykno-shadow with edge unsharpness and there was cavity in the lesion, single cavity was observed in 80.8% , inner wall was slick in 88.5% , air-fluid level was seen in 80.8%. Conclusion Esophageal carcinoma complicated with pulmonary abscess is secondary for the most part, with typical image appearance and atypical clinical manifestation.