实性肿块型肺隔离症误诊为肺肿瘤9例分析

Analysis of 9 patients with solid mass pulmonary sequestration misdiagnosed as lung tumors

目的总结实性肿块型肺隔离症的CT表现特点、临床特点、病理特征。方法对外院误诊为肺肿瘤后经来我院经病理证实的9例肺隔离症的临床和CT资料、病理资料进行分析。结果 9例中,女性5例,男性4例,中位年龄46岁。CT显示病变位于左肺下叶6例,位于右肺下叶3例。患者临床症状表现为反复咳嗽、咳痰5例,反复咯血3例,腰痛1例。均为叶内型。我院对病变行CT增强扫描、多平面重建(MPR)、最大密度投影(MIP),清晰的显示异常供血动脉及与邻近结构的关系。结论肺隔离症临床症状无特异性,初诊误诊率较高,CT增强扫描及MPR、MIP对鉴别肺隔离症有重要价值。对临床高度可疑或确诊为肺内型PS可行手术治疗。

Objective To summarize the CT features, clinical features, and pathological features of pulmo- nary sequestration. Methods The clinical data of 9 patients with pulmonary sequestration were retrospectively ana- lyzed, who were initially misdiagnosed as lung tumors. Results 5 patients were females and 4 males. Their average age was 46 years old. CT showed that 6 cases had lesions in the left lower lobe and 3 cases located in the right lower lobe. The clinical symptoms mainly included repeated cough and sputum （5 cases）, hemoptysis （3 cases ）, and lumbago （ 1 case）. The abnormal feeding artery and its relation with adjacent structures could be clearly performed by CT enhanced scan, MPR and MIP. Conclusion The clinical symptoms of pulmonary sequestration is lack of speei- ficity. Therefore, it is easily misdiagnosed. CT enhanced scan, MPR and MIP have important values in the identifi- cation of pulmonary sequestration.