肺炎型细支气管肺泡细胞癌1例并文献复习

One-casestudy of clinical features of pneumonia type of bronchioloalveolar cancinoma and its diagnosis

目的探讨肺炎型细支气管肺泡细胞癌的临床特征及诊断。方法 1例肺炎型细支气管肺泡细胞癌同时结合国内外文献复习。结果肺炎型细支气管肺泡细胞癌,首发症状以咳嗽、咯血及进行性呼吸困难为多见,实变肺密度低、蜂窝肺征、血管造影征尤其是血管高密度征、枯树枝征及多发腺泡结节是其胸部CT的主要表现特点。结论肺炎型细支气管肺泡细胞癌临床及影像学表现多样,易误诊误治,经支气管镜肺活检及支气管肺泡灌洗找脱落细胞是诊断肺炎型细支气管肺泡细胞癌的可靠方法。

Objective To investigate the clinical manifestations and diagnosis of pneumonia type of bronchioloalveolar cancinoma.Methods One case of pneumonia type of bronchioloalveolar cancinoma was observed with HE and immunohistochemical stain.The literature review was conducted.Results The first and early symptoms of pneumonia type of bronchioloalveolar cancinoma are cough,hemoptysis and progressive dyspnea in most cases.Low density of the consolidation,honeycomb sign,angiogram sign especially high density of vessel sign,leafless tree sign and multi-acinarnodules were the main characteristic features in CT.Conclusion The clinical features and imaging manifestations of bronchioloalveolar cancinoma are varied,and very apt to be misdiagnosed.Trans bronchoscopic lung biopsy and bronchoalveolar washing to look for deciduous cell are considered as the useful method in the diagnosis the bronchioloalveolar cancinoma.