先天性支气管囊肿的影像诊断及病理学分析

Imaging representation and pathological features of congenital bronchial cyst

目的先天性支气管囊肿的影像诊断及病理特点。方法回顾性分析我院9例经手术病理证实的先天性支气管囊肿的影像诊断表现。结果根据X线胸片、胸部CT检查结果,本组患者病灶肺内型5例,纵隔型3例,异位型1例。其中液囊肿4例、气囊肿3例、多发肺囊肿2例。①肺内型多以并发感染就诊,其中3例为咳嗽、咳痰,1例伴发热;其CT特征为囊腔大、周围软组织少的块中囊,或呈薄壁的空腔、多发性蜂窝状、囊腔状环形透光影。②纵隔型2例与体检时偶然发现,1例因囊肿压迫气管而出现胸闷、呼吸困难;其CT特点为边界清楚、密度一致的孤立性圆形或卵圆形阴影,与周围器官组织相互挤压变形。③异位型1例于体表扪及囊性包块就诊。病理检查:镜下均可见囊壁内衬假复层纤毛柱状上皮、腺体、软骨、弹力纤维和少量平滑肌。结论先天性支气管囊肿以肺内型为多,CT检查以块中囊为其特征性表现,组织病理学检查均具备呼吸上皮、腺体、软骨和平滑肌。手术切除是治疗的最佳方案。

Objective To study the imaging representation and pathological features of congenital bronchial cysts. Methods X-ray,CT and histopathological manifestations were retro spectively reviewed in 9 patients with congenital bronchial cysts. Results There were 5 patients with intrapulmonary bronchogenic cysts,3 patients with mediastinal bronchogenic cysts, and 1 patient with ectopic bronchogenic cyst. Of the 9 patients,4 were liquid cysts, 3 air cysts,and 2 mulfiplepulmonary cysts. Intmpulmonary congenital bronchial cysts were diagnosed always due to infection. There of 5 patients presented with cough,sputum production, l accompanied by fever.The imaging features were bag included mass, which was characterized by a big bag surrounded by a little soil-tissue, or thin walled cavity, or multiple honeycomb or cystoid circular translucency. Two of 3 patients with mediastinal bronchogenic cysts incidentally discovered on a radiograph obtained for other reasons were almost asymptomatic, 2 presented with dyspnea due to compression of trachea. The imaging features included isolated well-defined round shape or ovoid sofe-tissue mass with isodensity,and mutual compression between the surrounding organs. One patient with ectopic bronchogenic cysts were diagnosed due to cystic mass on chest wall. Pseudostratified ciliated columnar epithelium,gland, cartilage, elastic fiber and smooth muscle were all confirmed by light microscopy. Conclusion The main type ofcongenitai bronchial cysts is intrapulmonary bronchogenic cysts. The imaging feature is bag included mass on CT scan.A lining of respiratory epithelium associated with a wall containing glands,cartilage and smoothmuscle is the histopathologic feature for diagnosing congenital bronchial cysts.The optimal treatment is surgical resection.