结核瘤和周围型肺癌的诊断分析(附238例X线与病理对照)

Diagnosis investigation on tubercoluma and lung cancer

目的;探讨结核瘤与周围型肺癌的鉴别诊断。方法:分析经病理证实的145例结核瘤和93例周围型肺癌的临床症状、胸片、断层X线片和CT等影像学表现及实验室资料,并将病灶的影像学表现对照具体标本的病理发现,寻找重要鉴别诊断征像。结果:分叶轮廓、毛刺状外缘、空泡征、卫星病灶、胸膜改变、钙化点等为重要征像,其中分叶状轮廓、毛刺状外缘、空泡征以及胸膜改变等尤其需要细致辨认。结论:应用这些重要鉴别诊断征象,结合病史和结核瘤的阳性检查结果,可帮助鉴别诊断结核瘤和肺癌,避免误诊。

Objective For the purpose to find the possible reasons causing pulmonary tuberculoma which has been misdiagnosed as lung cancer. Method Clinical symptoms, chest X ray films, tornographic and CT manifestations as well as laboratory data of 145 cases of pulmnary tubercoloma and of 93 lung cancerathologically proved were thoroughly reviewed. All the radiological appearances were compared with pathological findings. Results Shallow lobulated contour, spurlike shadow formation, vacoule sign, satellite lesions, pleural involvement, calcified spots were found very important for differential diagnosis of these diseases. Conclusion It is difficult to differentiate pulmonary tuberculima from lung cancer. By paying special attention to the above mentioned appearance, evaluating them very carefully and considering them with Positive laboratory findings, it might be possible to avoid misdiagnosis before surgical operation.