肺隐球菌病65例影像表现和病理分析  

Analysis of the Imaging and Pathological Characteristics of 65 Cases of Pulmonary Cryptococcal Disease

作　　者：王松松 陈秀梅 马勇 陶智慧 WANG Songsong;CHEN Xiu-mei;MA Yong(Harbin 242 Hospital,Harbin 150060,China)

机构地区：[1]哈尔滨二四二医院,哈尔滨150060

出　　处：《航空航天医学杂志》2021年第9期1034-1035,共2页Journal of Aerospace medicine

摘　　要：目的探讨肺隐球菌病的影像和病理学特征。方法选择2016年1月-2021年3月收治的65例肺隐球菌病患者为研究对象,对其临床资料进行分析。结果本组的65例患者,经CT检查,其病灶以胸膜下为主;51例为孤立性病变,占78.46%,其中21例为左肺,30例为右肺;14例为多灶病变,占21.54%,主要为单叶多发;形态上,结节/肿块型病变59例,占90.77%,其中49例为单发,10例为多发,可评估病灶共70个,3例为混合型,占4.62%,3例为斑片型,占4.62%;结节/肿块型病变合并征象,20个为晕征,占30.77%,16个为毛刺征,占24.62%,14个为分叶征,占21.54%,9个为支气管充气征,占13.85%;同时,病理形态以多核巨细胞、上皮样细胞以及组织细胞聚集而成的肉芽肿性炎为主要表现,其中15例合并机化、8例合并坏死、3例为机化合并坏死;经六胺银、PAS染色,可见阳性隐球菌孢子。结论胸膜下是肺隐球菌病的一个多发部位,形态上主要为单发结节/肿块,往往合并分叶征、晕征、支气管充气征以及毛刺征,其组织病理特征为肉芽肿性炎,可合并机化和坏死,并且行特殊染色,可以提高诊断准确率。Objective To investigate the imaging and pathological characteristics of Pulmonary Cryptococcus disease. Methods 65 patients with cryptococcal disease from January 2019 to March 2021 were selected, and their clinical data were analyzed. Results 65 patients in this group, After the CT inspection, Its lesions are mainly subpleural areas;The 51 cases were isolated lesions, At 78.46%, Of these, 21 were the left lung, Thirty cases were the right lung;The 14 cases were multifocal lesions, For 21.54%, Mainly for the single leaf multiple;Morphally, 59 cases of nodules/mass lesions, For 90.77%, Of these, 49 were single hair, Multiple in 10 cases, There were 70 assessed lesions, Three cases are of mixed-type, For 4.62%, Three cases were spotted type, accounting for 4.62%;Combined features of nodules/mass-type lesions, Twenty cases are halo signs, For 30.77%, Sixteen are for burrs, For 24.62%, Fourteen are leaf foliation, For 21.54%, Nine are bronchial inflation characteristics, accounting for 13.85%;Meanwhile, the same The pathological morphology is mainly manifested by granulomatomitis gathered by polonuclear giant cells, epithelial cells and tissue cells, Among them, 15 cases combined organic necrosis, 8 combined necrosis and 3 cases were organic combined necrosis;Dtained by hexamine silver, PAS, Positive Cryptococcus spores can be seen. Conclusions Subpleural is a frequent part of pulmonary cryptococci, mainly single nodules/lumps, often combined with foliation, halo, bronchial inflation and burr. The histathological characteristics are granulomatitis, which can combine mechanization and necrosis, and perform special staining, which can improve the diagnostic accuracy.

关 键 词：胸膜下 CT 肺隐球菌病 单发结节/肿块 

分 类 号：R814.42[医药卫生—影像医学与核医学]