肺大泡伴双肺弥漫性结节一例并文献复习

Pulmonary Bulla and Bilateral Diffusely-distributed Nodules:Report of One Case and Literature Review

肺癌在影像学上多表现为肺部的实质性肿块,极少数患者没有上述典型表现,而是以双肺弥漫分布的小结节、特殊表现的肺大泡等为特征,极易被误诊、漏诊。北京协和医院于2016年11月24日至12月19日收治了1例肺大泡伴双肺弥漫性小结节的患者,胸部高分辨CT检查示双肺多发结节影,以双上肺为著,累及胸膜及叶间裂,部分伴囊状改变,左上肺可见一肺大泡,大泡壁部分增厚,可见结节影,经支气管镜肺活检病理证实为肺腺癌。

Lung cancer is mostly characterized by a pulmonary solid mass on CT.In rare cases,patients do not have these typical manifestation but present with diffusely-distributed small nodules and pulmonary bullae,which can easily be misdiagnosed.A special case of lung adenocarcinoma was managed in our hospital from September 24th to December 19th in 2016.Under high-resolution CT,multiple nodules were seen in both lungs,mostly in the upper lungs,involving the pleura and interlobular fissures.Some nodules had cystic changes.A large bulla was seen in the left upper lung.Its wall was thickened with multiple nodules.Lung adenocarcinoma was pathologically confirmed.