摘要
目的观察肺隐球菌病(PC)肺 部CT增强扫描影像学表现及病理特点。方 法 回顾性分析自2009年1月-2015年1月于 我院经手术病理证实为肺隐球菌病的54例 患者的临床资料,所有患者均接受肺部CT 增强扫描,记录其影像学表现,并与病理 结果作对照分析。结果 本组肺部CT检出 多发结节型30例,单发结节型18例,实变 型6例,以病变区域位于胸膜下端,与胸 膜宽基底相贴,呈炎性肉芽肿改变,呈坏 死,无钙化为CT特征,病理可见肉芽肿样 病变,PAS(+)、CMS(+)。结论 PC其 特异性CT征象为病变区域位于胸膜下端, 与胸膜宽基底相贴,病变呈炎性肉芽肿改 变,呈坏死表现,无钙化,对非典型病变 者,配合病理穿刺活检可提升其诊断准确率。
Objective To investigate the imaging findings and pathological features of pulmonary CT enhancement scan of pulmonary cryptococcosis (PC). Methods The clinical data of 54 patients who had PC confirmed by surgery and pathology and were admitted into the hospital during January 2009 to January 2015 were retrospectively analyzed. All patients underwent CT enhancement scan. The imaging findings were recorded and compared with pathological results. Results There were 30 cases of multiondule type, 18 cases of solitary nodule type and 6 cases of consolidation type detected by pulmonary CT. The lesion areas were located at the lower end of the pleura and were close to the wide base of pleura. The CT findings showed changes of inflammatory granuloma, thanatosis and non-calcification. Pathology indicated granuloma-like lesions, PAS(+) and CMS(+). Conclusion The specific CT findings of PC are lesion areas located in the lower end of the pleura and close to the wide base of pleura. The lesions manifest as changes of inflammatory granuloma, thanatosis and non-calcification. For patients with atypia lesions, the diagnostic accuracy can be improved, combined with pathological biopsy
【关键词】肺隐球菌病;CT增强扫描;病理特征
【中图分类号】R73;R81
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.01.019
前言
肺隐球菌病主要由感染新型隐球菌引起,以内脏侵袭性为主要特 点,多呈慢性或亚急性疾病,侵犯人体中枢神经系统、肺部及骨骼, 致病机制复杂[1]。近年来,随着糖皮质激素、广谱抗生素、生物制剂 及免疫抑制剂的广泛应用,肺隐球菌病感染的发病率亦逐年提升[2]。 一般患者在患病早期无特异性症状表现,实验室检查亦无明显异常, 且影像学表现复杂多样化,通常被误诊为肺结核、肺炎及肺癌,临床 诊断困难[3]。鉴于此,为探讨早期确诊肺隐球菌病的有效方案,我院 对收治的54例患者的临床资料进行了回顾性分析,现报道如下。
中国CT和MRI杂志
第14卷, 第 1 期
2016年01月
相关文章