30例肺肉芽肿性病变误诊为肺癌的临床与影像分析

Clinical and imageological analysis on 30 cases of pulmonary granuloma misdiagnosed as lung cancer

目的分析30例肉芽肿性病变误诊为肺癌的病例，探讨减少误诊的对策。方法回顾分析1995-2009年临床影像诊断为肺癌，而病理证实为肉芽肿性病变的病例、探讨误诊对策。结果病灶以单发居多；大小直径由2．0cm-6．0cm不等；影像表现不规则团块影21例，圆形结节或肿块影9例。CT平扫大部分密度不均匀，部分可见中心稍低密度区域，增强后16例呈均匀性强化。病灶边缘大多不清楚。结论认真分析临床症状与影像表现，注意鉴别并增加多种检查方法的互补可减少误诊。

Objective To study 30 cases of pulmonary granuloma misdiagnosed as lung cancer. Method To retrospectively analyze cases from 1995 to 2009 that were imageologically misdiagnosed as lung cancer while whose pathology turned out to be pulmonary granuloma, and then to figure out the strategy for misdiagnosis of this kind. Results Most of the cases were solitary nodules, whose diameter varied from 2.0 - 6.0 cm. Irregular mass were observed in 21 cases while round or lump mass in 9 cases. And uneven and partial lower density in the centre of the mass was observed in most cases in plain scan. Even intra - neop/asma enhancement was observed in 16 cases while uneven in the other 14. Clear margin were seldom found in these cases. Conclusion To avoid misdiagnosis,clear differential diagnoses and seriously study on clinical manifestations between imageological findings is necessary,and some other methods of imagiology may be a complementation.