CT定位下经皮肺活检诊断肺炎性假瘤的价值分析

Analysis of the diagnostic value of CT-guided percutaneous lung biopsy for pulmonary inflammatory pseudotumor

目的分析CT引导下经皮肺活检(CT-LB)诊断肺炎性假瘤PIPT的价值。方法对57例经CT-LB诊断或误诊的PIPT手术治疗病例进行分析。结果术前CT-LB诊断PIPT的49例中,术后诊断PIPT 44例、鳞癌2例、结核球1例、错构瘤1例、腺癌1例;另8例术前CT-LB诊断结核球1例、鳞癌1例、腺癌1例、可见较多炎性细胞浸润但不能明确诊断5例,术后均诊断PIPT。结论 CT-LB诊断PIPT与术后病理诊断符合率高,对怀疑PIPT的肺周围型肿块患者可作为首选;为减少假阴性率,对CT-LB不能明确诊断但可见较多炎性细胞浸润者,需结合临床及其它辅检,综合诊断。

Objective To analysze the diagnostic value of CT-guided percutaneous lung biopsy （CT-LB） in the treatment of pa- tients with pulmonary inflammatory pseudotumor （PIPT）. Methods 57 cases which were diagnosed or misdiagnosed as PIPT by CT-LB were retrospectively studied. Results The final diagnosis after the surgery of 49 cases which were diagnosed as PIPT by CT-LB before the surgery was as follows ： 44 cases as PIPT, 2 cases of squamous carcinoma, 1 case of tuberculoma, 1 case of hamartoma 1 case, and 1 case of adencarcinoma. The diagnosis of the other 8 cases by CT-LB before the surgery was as follows： 1 case of tuberculoma, 1 case of squa- mous carcinoma, 1 case of adencarcinoma, 5 cases unidentified with many inflammatory infiltrating cells. The 8 cases were confirmed as PIPT after the surgery. Conclusion The diagnosis of PIPT by CT-LB has high coincidence with surgery biopsy, thus it shall be chosen as the first choice for if there is suspicion for pulmonary peripheral tumor. In order to reduce false negative rate, in the cases with many in- flammatory infiltrating cells, clinic and other secondary inspections should be combined as diagnosis means.