细支气管肺泡细胞癌的影像学诊断与鉴别诊断

Diagnosis and differential diagnosis of bronchioloalveolar carcinoma

目的:探讨细支气管肺泡细胞癌(BAC)的X线、CT诊断,X线分型与鉴别诊断。方法:回顾分析28例病理证实的BAC的影像学表现。结果:单纯结节或肿块型21例,肺炎实变型5例,弥漫型2例。单纯结节或肿块型可见空泡征、毛刺征、胸膜牵拉征、支气管征,血管聚束征;肺炎实变型呈边界不清斑片状毛玻璃样影;弥漫型呈弥散分布大小不等结节影。结论:BAC影像学表现多样化,应与肺炎、肺结核球、血行播散型肺结核、肺转移瘤、肺蛋白沉积症鉴别。

Objective ：To investigate the X-ray and CT diagnoses of bronchioloalveolar eareinoma（BAC） and to investigate its type and scale on X-ray and its differential diagnosis. Methods：28 cases of imaging manifestations of BAC confirmed by pathology were reviewed and analysed. Results：Of the 28 cases,single-nodule-type（or mass-type） was demonstrated in 21, pneumonia --consolidation-type in 5, and permeation type in 2. The vacuole sign, spicule sign, pleura drawing sign, bronehia sign,and blood vessel gathering sign might be seen in the single-nodule-type （or mass-type）. The pneumonia -consolidation-type of BAC appeared as the ground-glass shadows whose edges were poorly defined and presented as the patchy shape.The diffuse type of BAC presented the nodus shadows dispersive distributing and in inequality of size. Conclusion：The imaging manifestations of BAC were various,and should be differentiated from pneumonia,pulmonary tuberculoma,hematogenous disseminated pulmonary tuberculosis,pulmonary metastasis,and pulmonary alveolar proteinosis, PAP.