伴薄壁空腔形成的周围型肺癌的CT表现及误诊分析

发布时间：2018-11-18 08:55

【摘要】：目的探讨伴薄壁空腔形成的周围型肺癌CT表现特点及其形成的病理基础,提高对此种特殊形态类型肺癌的认识及警惕性,减少临床误诊率。方法回顾性分析首次诊断错误,后经复查及手术和(或)病理证实的周围型肺癌伴薄壁空腔形成患者12例的CT及临床资料。所有患者均行CT检查,着重分析空腔壁厚度与均匀性、有无内壁结节、腔内有无分隔或血管影通过、动态变化以及空腔与病灶实性部分的关系。结果所有病灶均为单发,右肺5例,左肺7例,均位于肺中外带近胸膜处。腺癌11例,鳞癌1例。其中8例误诊为肺结核,3例误诊为陈旧性病灶伴大泡形成,1例误诊为大泡伴感染。CT均表现为大小不一境界清晰的圆形或类圆形或不规则形空腔影伴(或)不伴有壁结节。其中9例空腔壁不均匀增厚,厚在1~4 mm;9例中6例见壁结节,5例内见粗细不均的分隔影,其余3例空腔壁较为菲薄且均匀,所有空腔内均为气体,无气-液平形成。结论对伴薄壁空腔形成的周围型肺癌的CT表现认识不足是造成误诊的主要原因,但该类型的肺癌仍有一定的特点,空腔壁的不均匀增厚及伴壁结节以及腔内间隔影均有助于提示该类型肺癌的临床诊断。
[Abstract]:Objective to investigate the CT features and pathological basis of peripheral lung cancer with thin-walled cavity formation, to improve the awareness and vigilance of this special type of lung cancer, and to reduce the rate of clinical misdiagnosis. Methods the CT and clinical data of 12 patients with peripheral lung cancer with thin-wall cavity formation confirmed by operation and / or pathology were analyzed retrospectively. All the patients were examined by CT. The relationship between the thickness and uniformity of the cavity wall, whether there was an inner wall nodule, whether there was a septum or vascular shadow, the dynamic changes and the relationship between the cavity and the solid part of the lesion was analyzed. Results all lesions were single, 5 cases of right lung and 7 cases of left lung. There were 11 cases of adenocarcinoma and 1 case of squamous cell carcinoma. Among them, 8 cases were misdiagnosed as pulmonary tuberculosis, 3 cases as old lesions with bullae formation, and 1 case as large vesicle with infection. CT showed circular or round or irregular cavity with or without wall nodule. In 9 cases, the wall of the cavity was thickened unevenly, the thickness of the wall was 1 mm;9 in 6 cases, the thickness of the wall was uneven in 5 cases, and the wall of the other 3 cases was thinner and more uniform. All the cavity walls were gas, and there was no gas-liquid flat formation. Conclusion the CT findings of peripheral lung cancer with thin-walled cavity formation are the main causes of misdiagnosis, but there are still some characteristics in this type of lung cancer. The inhomogeneous thickening of the cavity wall, accompanied by wall nodule and intraluminal septal shadow are helpful for the clinical diagnosis of this type of lung cancer.
【作者单位】：南京江北人民医院放射科;
【分类号】：R734.2;R730.44

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