弥漫实变型细支气管肺泡癌HRCT随访观察

Sequential High-resolution CT Findings in Bronchioloalveolar Carcinoma of Diffuse Consolidative Type

目的 探讨弥漫实变型细支气管肺泡癌 (DCBAC)的HRCT特征和动态变化特点。资料与方法 回顾分析经病理证实的 7例DCBAC的CT和HRCT表现 ,3例行 3～ 4次CT随访观察。分别记录病变范围、形态表现、动态变化。结果 叶、段型肺实变 7例 ,伴“枯树枝征”4例 ,“蜂窝征”4例 ,叶间裂膨隆 5例 ,磨玻璃密度影 6例和腺泡结节 7例。动态变化 :肺实变范围扩大 ,原为腺泡结节和 /或磨玻璃密度影的区域发展为肺实变。结论 多发的叶、段实变伴“蜂窝征”、叶间裂膨隆和远离实变区的腺泡结节和磨玻璃密度影是DCBAC的特征性表现 ;

Objective To analyze high-resolution CT (HRCT) features and their dynamic changes of diffuse consolidative type bronchioloalveolar carcinoma (DCBAC).Materials and Methods CT and HRCT findings of 7 cases with pathologically-proved DCBAC were retrospectively analyzed. Sequential CT scans were obtained in 3 patients during a follow-up period of 5～18 months. The lesion's extent, distribution, morphology and dynamic changes were observed. Results HRCT findings of DCBAC included lobar or segmental consolidation (n=7), “withered tree” sign (n=4), “honeycomb” sign (n=4), bulging of interlobar fissure (n=5) and acinar nodules (n=7). On dynamic observation, enlarging of pulmonary consolidation and merging of acinar nodules and/or ground-glass opacity into consolidation shadow could be seen.Conclusion Multiple lobar or segmental consolidation, together with “honeycomb” sign, bulging of interlobar fissure, and ground-glass opacity or acinar nodules at the regions far away from consolidation area are the imaging characteristics of DCBAC. HRCT combined with dynamic observation is helpful for the diagnosis of DCBAC.