肺郎格汉斯细胞组织细胞增生症的临床、X线、CT表现(2例报告并文献复习)

Clinical,X-ray radiography and CT features of pulmonary Langerhans cell histiocytosis(two cases report and literature review)

目的探讨肺郎格汉斯细胞组织细胞增生症(PLCH)的临床、X线及CT表现,以提高对该病的影像学认识。方法回顾性分析2例病理证实的PLCH患者的临床、X线和CT资料。2例患者均行胸部螺旋CT、高分辨CT(HRCT)扫描及X线胸部平片摄影,1例行头颅CT扫描。结果 2例患者CT及HRCT均为双中上肺野广泛分布的高密度小结节状影、纤维条索影及囊状和蜂窝状影。1例头颅CT示右枕骨局限性骨质破坏;胸部平片示双肺野透光度减低,双肺纹理模糊;另1例胸部平片示双肺纹理紊乱,右肺中野可见多个小囊状低密度区;纵隔影明显增宽。结论 PLCH的X线、CT及HRCT表现有一定的特征性,尤其是HRCT显示病变更加清晰,结合临床资料可提高对此病的诊断,确诊仍需病理学诊断。

Objective To investigate the clinical,X-ray and CT findings of pulmonary Langerhans cell histiocytic hyperplasia（PLCH）,improve the imaging recognition of PLCH.Methods Clinical,X-ray and CT data of two patients with pathologically confirmed PLCH were retrospectively analyzed.Two patients underwent chest spiral CT examination including high resolution CT（HRCT） scan and chest X-ray radiography.Head CT scan was performed in one patient.Results Widely distributed high-density small nodules,fibrous bands,cystic and honeycomb shadow in the lung fields was revealed on the CT and HRCT in two patients.Head CT in one patient showed limited bone destruction in right occipital bone.Chest X-ray radiography showed dual lung field transmittance is reduced dual markings vague;one cases of chest plain film shows pairs of markings and more chaos,right lung in the wild can be seen a number of small cystic low-density areas;obviously enlarged mediastinal shadow.Conclusion PLCH has certain characteristics on the CT and X-ray radiography,especially on HRCT.HRCT can show the lesions more clearly.The radiological findings combined with clinical data can improve the diagnosis.However,the confirmation still needs pathological diagnosis.