肺癌化疗后继发真菌感染的CT特点

CT features of fungal infection after chemotherapy for lung cancer

目的探讨肺癌化疗后继发真菌感染的CT特点。方法选择2009年1月-2010年6月医院收治的肺癌化疗后继发真菌感染患者25例,全部患者均经肺癌和肺真菌感染的临床诊断标准确立诊断,其中鳞癌患者15例,腺癌患者8例,小细胞肺癌患者2例;而白色假丝酵母菌感染患者20例,曲霉菌属感染患者4例,隐球酵母菌属感染患者1例;同时全部患者均行胸部CT检查。结果 25例患者中,CT检查显示12例患者在基础疾病之外出现磨玻璃影的特点;10例患者在基础疾病之外出现炎性大片实变的特点;2例患者呈散在分布斑片状阴影,且边缘较为模糊,其密度较淡并以中、下肺分布为主,也有部分融合呈大斑片状密影的特点;另有1例患者呈现出右下叶背段结节影伴有"空气半月征"的特点。结论肺癌化疗后继发真菌感染的影像学检查资料往往缺乏特异性,尤其在影像学特点上与一般肺炎很难区别,如果患者存在深部真菌感染的危险因素时,则应进一步根据相关临床诊断标准进行明确诊断,从而有效确定肺癌化疗患者有无继发真菌感染现象发生。

OBJECTIVE To probe into the CT features of fungal infection after chemotherapy for lung cancer.METHODS A total of 25 cases with lungs cancers after chemotherapy and with secondary fungal infection during Jan 2009-Jun 2010 were selected.All patients were confirmed by the diagnostic criteria of lung cancer and pulmonary fungal infection diagnosis,of which 15 patients with squamous cell carcinoma,adenocarcinoma 8 patients,2 cases of small cell lung cancer;and Candida albicans infection in 20 patients,4 patients with aspergillus infection,cryptococcal infection in 1 case.All patients were also underwent chest CT.RESULTS In this study of 25 patients,CT examination revealed the underlying disease in 12 patients outside the ground glass characteristics appear;10 patients appeared in the underlying inflammatory disease,a large addition to the characteristics of real change;2 patients were scattered in the spot Flake shadow,and the edge was vague,its density was lighter and in the middle and lower lung distribution mainly,but also showed some great fusion of the characteristics of patchy dense shadow;another 1 patient showing a right lower section of the dorsal tubercle film with an ＂air half sign＂ feature.CONCLUSIONS Imaging data of lung cancer fungal infection after chemotherapyoften lacks specificity,particularly in the imaging characteristics of pneumonia,which is difficult to distinguish from the general.If patients with deep fungal infection risk factors should be further carried out according to clinical diagnostic criteria diagnosis,it can effectively determine whether the patients with lung cancer chemotherapy fungal infection occurs.