54例肺炎性假瘤临床分析

目的进一步认识肺炎性假瘤（inflammatory pseudotumor of the lung，IPL）的临床特点，以期提高诊治水平，降低误诊率。方法回顾性分析54例肺部炎性假瘤患者的临床资料。结果既往有呼吸感染史42例（77．7％），10年以上吸烟史22例（40．7％）；临床症状缺乏特异性，以呼吸系统症状为主要临床表现；影像学特点主要为肺外周带近胸膜处类圆形或不规则形孤立阴影，密度均匀，边缘光滑，桃尖征（24％）和平直征（20．3％）为CT特征性表现，具有较高的诊断价值；术前误诊率高（75．9％），极易与肺癌相混淆；纤维支气管镜、PET-CT的诊断价值有限，确诊依据病理检查；全部病例手术治愈，预后良好。结论肺炎性假瘤临床症状缺乏特异性，影像学表现具有一定的特征性，确诊依据病理检查，手术切除是首选的治疗方法。

Objective The aim of the clinical analysis to further recover the clinic characteristics of lung inflammatory pseudotumor, improve its diagnosis and treatment level, reduce its misdiagnosis rate. Methods The clinical data of 54 patients with pulmonary inflammatory pseudotumor was retrospectively analyzed. Rssults： In the 54 cases, there are 42 patients with history of respiratory infection （ 77.7% ） , 22 patients with above 10 years smoking history （ 40.7% ） . Lung inflammatory pseudotumor lacks the specific clinical symptoms with common respiratory system symptoms as its main clinical manifestations. Imaging characteristics mainly include the similar round or irregular isolated shadow with uniform density and smooth edges in lung peripheral zone, especially near the pleura. Furthermore, the ＂Peach-tip＂ （ 24% ） and ＂fiat-line＂ signs （ 20.3% ） are its specific CT representations possessing good diagnostic value. Lung inflammatory pseudotumor has a high preoperative misdiagnosis rate （ 75.9% ） , easily is confused with lung cancer. Fiberoptic bronchoscopy and PET-CT diagnostic value is limited and its confirmative diagnosis is dependent on the pathological measurement. All cases were cured by surgery operation with a good prognosis. Conclusion Lung inflammatory pseudotumor lacks specific clinical symptoms, but has certain characteristic imaging manifestations. Its confirmative diagnosis is dependent on the pathological measurement and surgical resection is the preferred treatment method.