肺炎型细支气管肺泡癌6例临床分析

Clinical analysis of 6 patients with pneumonic-type bronchioloalveolar carcinoma

目的提高对肺炎型细支气管肺泡细胞癌(bronchioloalveolar carcinoma,BAC)的临床及影像学特点的认识。方法对2006年1月至2011年7月在巢湖市第一人民医院确诊的6例肺炎型BAC患者的临床症状、影像学特点、误诊情况等资料进行分析。结果 6例BAC患者男女各3例,年龄为47～78岁。6例中5例以咳嗽、咳痰为首发表现,其中咳大量泡沫痰2例,合并咯血1例,合并胸闷、呼吸困难2例。影像学检查主要表现为肺部实变及磨玻璃样影,位于周边部。2例经手术后标本病理确诊,4例经皮肺穿刺活检病理确诊。结论肺炎型BAC易误诊,咳嗽、咳痰为其主要症状,影像学检查以肺部实变影为主。经皮肺穿刺活检对肺炎型BAC诊断帮助较大。

Objective To understand the clinical and imaging characteristics of pneumonic-type bronchioloalveolar carcinoma（BAC）.Methods The data of 6 cases of pneumonic-type BAC from January 2006 to July 2011 were collected for a retrospectively review.The clinical and imaging features,and the causes underlying misdiagnosis were analyzed.Results There were 3 male and 3 femal（mean age 58 years,rang from 47-78 years）.The onset symptoms of BAC included cough,expectoration in 5 cases（2 patients accompanied by severe bronchorrhea;1 patient accompanied by Hemoptysis;2 patients accompanied by chest tightness,shortness of breath）.Imaging characteristics showed patchy areas of consolidation,ground-glass opacity,mostly in lung periphery.2 cases were pathologically proved by surgery specimens,4 cases by percutaneous needle biopsy.Conclusions Pneumonic-type BAC has high misdiagnosis rate.Cough and expectoration are the most common symptoms and Lung patchy consolidation is the main radiographic presentation of pneumonic-type BAC.Percutaneous needle biopsy is more valuable in diagnosis of pneumonic-type BAC.