老年人自身免疫性IgG4相关性肺疾病的多层螺旋CT表现  

MSCT manifestations of elderly autoimmune IgG4-related lung disease

作　　者：钟素华 李传旺[1] 邱清香 Zhong Suhua;Li Chuanwang;Qiu Qingxiang(Department of Radiology,the First Hospital of Longyan,Longyan 364000,China)

机构地区：[1]福建省龙岩市第一医院放射科,364000

出　　处：《实用医学影像杂志》2020年第6期603-605,共3页Journal of Practical Medical Imaging

基　　金：福建省临床重点专科建设项目资金支助(闽卫医政函〔2018〕145号)。

摘　　要：目的探讨老年人自身免疫性IgG4增高相关性疾病肺部受累的多层螺旋CT表现。方法回顾性分析该院8例经临床确诊的自身免疫性IgG4增高肺部受累患者的螺旋CT表现,总结其影像特征,所有患者均行256层螺旋CT扫描。结果4例不同程度肺间质性改变,4例伴多发小结节影,3例散在索条影及局限性肺气肿改变,轻度肺动脉高压1例,肺门及纵隔淋巴结钙化1例。其中1例肺部呈分叶状小结节并肺门、纵隔淋巴结肿大及肺内多发小结节影,手术前误诊为肺癌,后经病理及临床激素治疗后诊断为IgG4相关性肺疾病。结论老年人自身免疫性IgG4增高相关性疾病,肺部受累的MSCT表现多种多样,以炎性结节及肺部慢性纤维化表现多见,伴肺门及纵隔淋巴结肿大时应与肺癌鉴别。Objective To explore the multi-slice spiral CT manifestations of lung involvement in diseases associated with increased autoimmune IgG4 in the elderly.Methods Retrospective analysis of the spiral CT findings of 8 patients with clinically diagnosed autoimmune IgG4 increased lung involvement in the hospital,and summarized the imaging characteristics,All patients underwent 256-slice spiral CT scan.Results 1 case showed varying degrees of interstitial lung changes,4 cases with multiple small nodular shadows,3 cases of scattered cord shadow and localized emphysema changes,1 case of mild pulmonary hypertension,1 case of hilar and mediastinal lymph node calcification.Among them,1 case had ground glass-like nodules in the lungs with enlarged hilar and mediastinal lymph nodes and multiple small nodules in the lungs.It was misdiagnosed as lung cancer before surgery,and was diagnosed as IgG4-related lung disease after pathological and clinical hormone therapy.Conclusion Elderly patients with autoimmune IgG4 increase-related diseases,MSCT manifestations of lung involvement are diverse,with inflammatory nodules and chronic fibrosis of the lung more common,with hilar and mediastinal lymphadenopathy should be distinguished from lung cancer.

关 键 词：老年人 体层摄影术 螺旋计算机 肺疾病 免疫球蛋白g4相关性疾病 

分 类 号：R563[医药卫生—呼吸系统] R816.4[医药卫生—内科学]