肺泡蛋白沉积症的MSCT表现与病理对照分析  

MSCT findings of pulmonary alveolar proteinosis correlated with pathology

作　　者：马振波[1] 

机构地区：[1]泰安市中心医院放射科,山东271000

出　　处：《放射学实践》2012年第11期1198-1200,共3页Radiologic Practice

摘　　要：目的:通过分析肺泡蛋白沉积症(PAP)的MSCT表现与相应的病理改变,探讨MSCT对PAP的诊断价值。方法:经病理证实的9例PAP患者术前均行MSCT扫描,对其CT表现及其病理学改变进行对照分析。结果:PAP胸部影像表现呈多样化改变,其中碎路石样改变4例,地图样改变9例,肺实变表现(支气管充气征)6例,肺间质纤维化样表现3例。支气管肺泡灌洗液(BALF)石蜡包埋切片,显微镜下示片状嗜伊红性颗粒状蛋白性物质,其中可见针状裂隙。组织化学染色示肺泡腔内或BALF中嗜伊红性细颗粒状蛋白性物质淀粉酶消化后的过碘酸雪夫染色(D-PAS)阳性,奥新兰染色(AB)阴性。结论:PAP典型的胸部MSCT表现与病理改变一致,具有一定特征性,CT是临床诊断本病的有价值的方法。Objective：To study the features of pulmonary alveolar proteinosis （PAP） on multislice spiral computed tomography （MSCT） with correlation to pathology,and improve the early diagnosis accuracy of the disease. Methods： 9 ea- ses with pathology proved PAP underwent MSCT scans. The imaging features were analyzed retrospectively and correlated with pathology. Results：The radiologic features of PAP could be characterized as the crazy-paving pattern （n = 3）, geograph- ic （n= 9）, lobar or segmental consolidation （air-brochogram sign, n= 6） and intersititial fibrosis （n= 3）. Fragments of eo- sinophilic, fine granular proteinaceous material with needle-like clefts were found in the bronchoalveolar lavage fluid under light microscopy. The proteinaceous material was positive D-PAS staining and the alcian blue staining was negative. Conclu- sion： The characteristic findings of PAP on chest MSCT corresponded well with pathological changes.

关 键 词：肺疾病 肺泡蛋白沉积症 体层摄影术 X线计算机 病理学 

分 类 号：R563.9[医药卫生—呼吸系统]