肺内孤立病灶41例临床诊治分析

Clinical Analysis of 41 Cases of Solitary Pulmonary Nodules

目的探讨肺内孤立病灶的临床及影像学特点,提高诊治能力。方法自2008年1月至2013年12月经我院诊治的41例肺内孤立病灶确诊病例。回顾性分析本院经CT平扫或/增强扫描及HRCT检查,结合手术、肺穿、淋巴结穿刺活检、痰检病理结果,分析孤立病灶的特征及临床诊治情况。结果 41例病灶各有其特征,周围型肺癌CT主要表现为空泡征、支气管充气征、分叶征、毛刺征、血管集束征、胸膜凹陷征;肺内良性病变各有不同的CT特点,其中肺结核主要有空洞、钙化、卫星灶、胸膜粘连及肥厚改变。确诊肺癌19例(腺癌11例,鳞癌5例,小细胞癌2例,腺鳞混合癌1例),良性病变21例,其中结核病15例,炎性假瘤2例,错构瘤、孤立纤维瘤、肺脓肿及机化性肺炎各1例。结论肺内孤立病变各有其不同的影像学特点,病变的恶性程度较高,结合临床症状及查体,通过适合的检查方法进行诊断及鉴别诊断,并及早治疗。

Objective To explore the clinical and imaging characteristics of solitary pulmonary lesions, improve the ability of diagnosis and treatment. Methods 41 cases of solitary pulmonary lesions methods confirmed cases since 2008 January to 2013 12 menstrual period in our hospital. A retrospective analysis of our hospital by CT scan or / enhanced scan and HRCT examination, combined with surgery, lung biopsy, lymph node biopsy and sputum examination pathological results, analysis of the characteristics of isolated lesions and clinical situation. Results The lesions of 41 cases and each has its characteristics, CT of peripheral lung cancer mainly for vacuole sign, air bronchogram, lobulation, Mao Cizheng, vascular convergence sign, pleural indentation sign;pulmonary benign lesions respectively have the different features of CT, which are the main pulmonary tuberculosis cavity, calcification, satel ite lesions, pleural adhesion and hypertrophy change. 19 cases of lung cancer （11 cases, 5 cases of adenocarcinoma, 2 cases of squamous cel carcinoma, smal cel carcinoma, adenosquamous mixed carcinoma in 1 cases）, 21 cases of benign lesions, including 15 cases of tuberculosis, 2 cases of inflammatory pseudotumor, hamartoma, solitary fibrous tumor, lung abscess and organizing pneumonia with 1 cases in each. Conclusion Solitary pulmonary lesions and each has its different imaging characteristics of lesions of the malignant degree is high, combined with clinical symptoms and physical examination, diagnosis and differential diagnosis by checking method is suitable, and early treatment.