肺部良性病灶误诊肺癌的CT影像学分析  

CT Imaging Analysis of Benign Pulmonary Lesions Misdiagnosed as Lung Cancer

作　　者：郭红剑 GUO Hong-jian(Department of Radiology,Wuzhong People's Hospital of Ningxia,Wuzhong 751100,Ningxia,China)

机构地区：[1]宁夏吴忠市人民医院放射影像科,宁夏吴忠751100

出　　处：《中国CT和MRI杂志》2022年第12期71-72,126,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨肺部良性病灶误诊肺癌的CT影像学特点。方法回顾性分析2017年1月至2019年10月经CT首诊为肺癌患者80例,后经病理学证实63例肺癌患者,17例肺部良性病灶,比较患者一般资料,分析17例被误诊原因。结果两组患者性别、年龄、病程、临床表现均无显著差异(P>0.05);确诊组经病理检查结果示为肺癌患者。误诊组患者经病理检查结果示慢性炎症4例,慢性炎伴坏死、肉芽肿性炎伴坏死、慢性炎症伴肉芽肿、慢性肉芽肿、炎症伴机化、霉菌感染、变性坏死物、炎性细胞坏死、慢性炎症伴机化及肉芽肿形成、肺泡瘤、慢性化脓性炎伴机化性炎各1例;17例均见块影,其中右肺上叶5例,近右肺上叶2例,左肺上叶5例,左肺下叶3例,左肺门1例。14例患者呈不同程度明显占位病变,最大5.5cm×4.9cm,最小12×8mm。边缘毛糙5例,边界不清5例,边界清晰6例、空洞5例,其中1例为偏心性空洞,3例空洞内欠光滑。结节或肿块病灶现斑片状、团片状及结节状增强密度均匀影10例;结节或肿块病灶现斑片状、团块状、片状增强密度不均匀影7例。3例病灶内现钙化。1例肺下叶支气管扩张。7例病灶见条索状、网格状、囊柱状透明区。1例胸膜凹陷征。2例软组织影。结论肺部良性病灶误诊为肺癌病例的影像学特征与肺癌相似,应结合病例与临床资料分析病灶,同时应提高影像医师对良恶性病灶鉴别知识,以防误诊发生,提高诊疗质量。Objective To analyze the CT imaging of benign pulmonary lesions misdiagnosed as lung cancer.Methods 80 cases of CT diagnosed lung cancer in our hospital from January 2017 to October 2019 were enrolled,and 63 cases of them were pathologically confirmed(confirmed group),while the rest 17 cases were benign pulmonary lesions(misdiagnosis group).The general data of patients were compared and the causes of misdiagnosis in 17 cases were analyzed.Results There was no significant difference in gender,age,course of disease and clinical manifestation between groups(P>0.05).Pathological results showed that 16 cases in the misdiagnosis group included 4 cases of chronic inflammation,1case of chronic inflammation with necrosis,1 case of granulomatous inflammation with necrosis,1 case of chronic inflammation with granuloma,1 case of chronic granuloma,1case of inflammation with mechanization,1 case of mould infection,1 case of denatured necrosis,1case of inflammatory cell necrosis,1 case of chronic inflammation with mechanization and granuloma formation,1 case of alveolar tumor,1 case of chronic suppurative inflammation with mechanization 16 cases showed block shadow,including 5 cases of right upper lobe,2 cases of near right upper lobe,5 cases of left upper lobe,3 cases of left lower lobe and 1 case of left hilum.14 patients showed different degrees of space occupying lesions,the largest was 5.5cm×4.9cm,the smallest was 12×8mm.There were 5 cases with rough edge,5cases with unclear boundary,6 cases with clear boundary and 5cases with cavity,among which 1 case was eccentric cavity and 3 cases were not smooth.10cases showed patchy,patchy and nodular enhanced density homogeneous shadow;6 cases showed patchy,lumpy and patchy enhanced density inhomogeneous shadow.Calcification was found in 3cases.One case had bronchiectasis of lower lobe.In 7 cases,there were clear areas like cords,grids and cysts.One case had pleural depression.Soft tissue shadow was found in 2 cases.Conclusion The imaging features of pulmonary benign lesions misdi

关 键 词：肺部良性病灶 误诊 肺癌 CT影像学 

分 类 号：R445.3[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]