炎性假瘤的X线影像与临床诊断——附37例分析

Radiologic feature and clinical diagnosis of inflammatory pseudotumor - analysis of 37 cases

目的 提高对肺炎性假瘤的临床诊断正确率。方法 回顾性分析37例经手术后病理诊断证实的肺炎性假瘤的X线表现和临床症状。结果 37例中男10例,女27例,年龄10—68岁(平均43.9岁)。起病时无症状仅体检发现14例,有症状的23例中咳嗽13例,痰血16例,发热9例。X线片肿块影像特征:部位:右肺23例,左肺14例,以右下叶及中叶居多。大小:直径1.0—12cm。形状:圆形或类圆形者34例(91.89％),不规则3例。边缘光滑22例,模糊11例,分叶状3例,细毛刺1例。密度均匀25例,不均匀9例,有透亮区3例。结论 肺炎性假瘤是一种非特异性炎症所致的肿瘤样病变,在X线表现和临床症状与检查上虽有一定特征,可供确诊,但有时与肺癌难以辨别。对此宁愿早期手术切除,尤其是在胸腔镜下,预后良好。

Purpose To improve the accuracy of clinical diagnosis of inflammatory pseudotumor of lung. Methods 37 cases with inflammatory pseudotumor confirmed by pathological examinations were analyzed retrospectively. Results Among 37 cases (male 10, female 27, age range 10 - 68 years, mean 43.9 years) , 14 had no any symptom, only implied by physical examination and 23 were symptomatic, including cough in 13 cases, bloody or bloody tinged sputum in 16 cases, and fever in 9. The mass shadows had the following X - ray imaging characteristics: location: 23 cases in right lung, 14 in left, especially in lower and middle lobe (21/37); size: diameter 1.0- 12cm; shape: round or oval in 34 cases (91.89%), irregular in 3; margin: sharp in 22 cases, vague in 11, lobular in 3, thorns in 1, density: homogeneous 25 cases, uneven 9, with lighten area 3. Conclusion The inflammatory pseudotumor of the lung is a tumor- like lesion caused by an unspecific inflammation. Although it has some certain characteristics in X - ray images and clinical symptoms and signs for making accurate diagnosis, early surgical resection, especially under thoracoscopy was preferly selected, for getting a good diagnosis and prognosis, while it was difficult to be distinguished from lung cancer