不典型胸部结节病的CT表现

Atypical CT appearances in the thoracic sarcoidosis

目的 认识不典型胸部结节病的发生情况和CT表现。方法 回顾性复习了 4 3例 (平均年龄 5 2 14岁 )符合诊断标准的胸部结节病的CT影像表现 ,凡无两侧肺门淋巴结肿大者为不典型胸部结节病。结果 2 2例 (5 1 16 % )呈不典型表现 ,其中以仅有纵隔淋巴结肿大者最多 (9例 ,2 0 93% ) ,其次为伴纵隔淋巴结肿大的一侧肺门淋巴结肿大 (6例 ,13 95 % )和无纵隔淋巴结肿大的一侧肺门淋巴结肿大 (1例 ,2 33% ) ;6例仅有肺部异常表现 ,而无胸部淋巴结肿大 ,在初诊时均误诊。18例 (81 82 % )不典型者发生在 >5 0岁的病例中 ,仅 4例 (18 18% )发生在 <5 0岁的病例中。结论 半数胸部结节病病例的CT表现不典型 ,多发生在 >5 0岁的较年长者中 。

Objective To study the CT appearances in the atypical thoracic sarcoidosis Methods Chest CT findings of 43 patients with proven sarcoidosis were reviewed retrospectively Results 22 cases (51 16%) had atypical thoracic sarcoidosis findings at presentation The atypical patterns on CT included mediastinal adenopathy alone ( n =9) or in combination with unilateral hilar adenopathy ( n =6), and unilateral hilar adenopathy alone ( n =1) 6 patients had abnormal findings in the lung alone without adenopathy, and they all had been misdiagnosed 18 atypical cases (81 82%) occurred in patients older than 50 years, whereas 4 atypical cases (18 18%) occurred in patients younger than 50 years Conclusion Half patients with thoracic sarcoidosis have atypical CT appearances, it frequently occurs in elderly patients, and the diagnosis is easily mistaken on CT scan