肺炎型肺癌的MSCT影像学特点及其病理学对照

Pneumonia type carcinoma of lung： imaging classification and diagnostic value

目的探讨肺炎型肺癌的CT影像学特点及与病理学对照。方法回顾性分析33例经活检及手术等病理证实的肺炎型肺癌患者的临床、病理及影像学齐全的资料，总结其影像学特征，并与病理类型对照，探讨其在影像学诊断中的应用价值。结果33例肺炎型肺癌中细支气管肺泡癌23例，腺癌10例。其中单发肺叶实变21例（63．6％），单发肺段实变6例（18．1％），多发肺叶实变6例（18．1％）；实变肺伴血管造影征21例（63．6％），支气管气像征27例（81．8％），伴枯树枝征18例（54．5％）；实变肺周见蜂窝肺征27例（81．8％），磨玻璃征21例（63．6％），多发小结节6例（18．1％）；少量胸水3例（9．1％），肺门淋巴结肿大3例（9．1％）。病理证实细支气管肺泡癌17例，腺癌9例，腺鳞癌3例，小细胞癌1例。结论肺炎型肺癌的影像学形态可为多种多样，但其动态影像学表现具有一定特征性，确诊需要病理检查。

Objective To study the image features and pathologic basis of pneumonia type carcinoma of lung（PTCL）. Methods The clinical, pathological and serial imaging materials of 30 cases of PTCL proved by pathology were retrospectively analyzed. The image features of PTCL were summarized. Results The pathological types of PTCL included bronchioalveolar carcinoma in 21 eases and adenocarCinoma in 9 cases. The main CT findings of PTCL in 33 cases were consolidation, included single lobar or segmental consolidation （n = 27,81.8% ） ,muhilobar consolidation （ n = 6,18.1% ）. With in consolidation demonstrated lower density with angiogram sign （ n = 21,63.6% ） , and air bronchogram（n = 27, 81.8% ） with leafless tree sign （ n = 18,54.5% ） ; Outside of consolidation showed honeycomb sign （ n = 27,81.8 % ）, ground glass shadow （ n = 21,63.6% ）, multinodules （ n = 6,18.1% ）. The other findings included little pleural effusion （ n = 3,9. 1% ） ,. enlarged mediastinal lymph node （ n = 3, 9. 1% ）. Conclusions The imaging features of PTCL are varied, but the imaging dynamic changes of PTCL are of relative characteristic.