细支气管腺瘤临床、CT及病理学表现

Clinical,CT and pathological manifestations of bronchiolar adenoma

目的分析细支气管腺瘤(BA)临床、CT及病理学表现。方法回顾性分析经病理证实的15例BA患者临床、CT及病理学表现。结果15例中,14例无明显症状,1例胸痛。15例CT均见单发BA,11个病灶为混杂磨玻璃结节(mGGN)、3个为实性结节(SN)、1个为纯磨玻璃结节(pGGN),均位于外周带,紧贴或邻近胸膜,左、右肺下叶各5个,右肺上、中叶各2个,左肺上叶1个,最大径6.15~24.04mm、中位最大径9.10mm,CT值-553~47HU、中位CT值-297 HU;12个形态不规则、3个呈类圆形,10个边界清晰、5个边界模糊;14个见分叶征,11个见毛刺征,空泡征、支气管充气征及胸膜凹陷征各见于3个病灶,1个可见空洞。光镜下病灶内未见异型细胞,12个见特征性双层细胞结构,由腔面细胞层及基底细胞层构成。结论BA临床、CT及病理学表现均具一定特征性。

Objective To analyze the clinical,CT and pathological manifestations of bronchiolar adenoma(BA).Methods The clinical,preoperative chest CT and pathological data of 15 patients with BA confirmed by surgical pathology were retrospectively analyzed.Results Among 15 patients,1 complained chest pain,while 14 had no obvious clinical symptoms.Single BA was found in all 15 cases,including 11 mixed ground-glass nodules(mGGN),3 solid nodules(SN)and 1 pure ground-glass nodule(pGGN).All 15 BA located peripherally,near or adjacent to the pleura,including 5 in the left and 5 in the right lower lobe of lung,2 in the right upper lobe and 2 in the right middle lobe,and 1 in the left upper lobe of lung.The maximum diameter of the lesions ranged from 6.15 mm to 24.04 mm,with a median value of 9.10 mm.CT value of the lesions were-553—47 HU,with a median value of-297 HU.Twelve lesions shaped irregularly,while 3 lesions were oval,10 with clear and 5 with fuzzy boundaries.Lobulation,spiculation,bubble lucency,air bronchus sign,pleural indentation and cavity were detected in 14,11,3,3,3 and 1 lesion,respectively.No abnormal cell was detected under the microscopy in all 15 BA lesions,while the characteristic bilayer cell structures composed of luminal surface cell layer and basal cell layer were observed in 12 lesions.Conclusion The clinical,CT and pathological manifestations of BA had certain characteristics.