结节和肿块型局灶性机化性肺炎与肺癌的鉴别  

Differentiation of Focal Nodular and Mass-Type Organizing Pneumonia from Lung Cancer

作　　者：刘伟[1] 潘琳琳[1] 谢雪婷[1] 陈兴无[1] LIU Wei PAN Linlin XIE Xueting et al.(Department of Respiratory Medicine, Yijishan Hospital, Wannan Medical College, Wuhu ,Anhui Province 241001, P. R. China)

机构地区：[1]皖南医学院弋矶山医院呼吸内科,芜湖241001

出　　处：《临床放射学杂志》2017年第2期215-218,共4页Journal of Clinical Radiology

摘　　要：目的探讨结节和肿块型局灶性机化性肺炎(FNMOP)临床和CT特征,以提高与肺癌的鉴别诊断水平。方法搜集经病理证实的14例NMFOP患者的临床资料、实验室检查(肿瘤标记物和D-二聚体)及CT影像资料,并对这些资料进行回顾性总结分析。结果 14例患者中,病灶为圆形或类圆形者5例,不规则形9例;边缘清晰5例,病灶边缘模糊9例;浅分叶7例,深分叶3例;短毛刺1例,长毛刺2例;3例有血管集束征,8例有棘突征。右肺9例,肺上叶9例。结论结合临床资料、肿瘤标记物和D-二聚体及CT特征进行综合分析,有助于对FNMOP的鉴别诊断。Objective To explore the clinical and CT features in patients with focal nodular and mass-type organizing pneumonia（ FNMOP） so as to differentiate the lesions from lung cancer. Methods Clinical data,laboratory examination（ Tumor markers and D-dimer） and CT features of 14 patients with pathology-proven diagnoses of FNMOP from September2012 to December 2015 were extracted and retrospectively analyzed. Results Of the 14 patients’ CT performance,focal round or oval mass-like opacities were found in 35. 7%（ 5 of 14）,polygonal masses with irregular margins were seen in64. 3%（ 9 of 14）,5 cases（ 35. 7%） manifested as clear margind,opacities with indistinct borders were identified in64. 3%（ 9 of 14）. 7 cases（ 50. 0%） were identified as shallow lobulations,3（ 21. 4%） as deep lobulations,1（ 7. 1%）as short spiculations,2（ 14. 3%） as long spiculations,3（ 21. 4%） as vessel convergence,and 8（ 57. 1%） as spinous processes. The lesions were predominantly in the right lung（ 64. 3%）,with the upper lobe being the most commonly affected area（ 64. 3%）. Conclusion It will be helpful to differentiate FNMOP from lung cancer on the basis of clinical data,tumor markers,D-dimer and the pattern and distribution of abnormalities on CT.

关 键 词：机化性肺炎 结节和肿块型 肺癌 鉴别诊断 

分 类 号：R734.2[医药卫生—肿瘤] R563.1[医药卫生—临床医学]