肺内非感染性肉芽肿影像学表现与病理对照研究  

Comparative study on imaging and pathology of non-infectious granulomatous lung disease

作　　者：邓娟[1] 赵良清[1] 罗林[1] 蒋炜杰 DENG Juan;ZHAO Liangqing;LUO Lin;JIANG Weijie(Department of Radiology,Jianyang People's Hospital,Jianyang 641400,China;Department of Pathology,Jianyang People's Hospital,Jianyang 641400,China)

机构地区：[1]四川省简阳市人民医院放射科,四川简阳641400 [2]四川省简阳市人民医院病理科,四川简阳641400

出　　处：《医学影像学杂志》2023年第12期2196-2199,共4页Journal of Medical Imaging

基　　金：四川省医学科研课题计划项目(编号:Q161069)。

摘　　要：目的探讨肺内非感染性肉芽肿影像学表现与病理对照分析。方法选取我院就诊并最终经病理诊断为肺内非感染性肉芽肿患者72例,均行胸部CT检查。观察并分析影像学表现特征,总结肺内非感染性肉芽肿的一般资料、临床表现及影像学表现特征。结果肺内非感染性肉芽肿72例为多发病灶。结节病沿淋巴道分布且均观察到肺门及纵膈淋巴结肿大。韦格纳肉芽肿沿气道或胸膜下分布,病灶形态多样。亚急性过敏性肺炎病灶呈磨玻璃密度或小叶中心结节改变,部分病例可见树芽征改变。淋巴瘤样肉芽肿病沿气道分布或胸膜下分布,一半以上病例可见反晕征。坏死性结节状肉芽肿病多以胸膜下分布为主,病灶边界清晰。类风湿性肺结节多数病例有肺内空洞、卫星灶和肺间质改变。结论结合临床及影像学特点的综合分析判断,有利于肺内非感染性肉芽肿的诊断和鉴别。Objective To conduct a comparative study on imaging and pathology of non-infectious granulomatous lung dis⁃ease.Methods A total of 72 patients with non-infectious pulmonary granuloma diagnosed by pathology in our hospital were se⁃lected.All patients underwent chest CT examination after admission.Then,we observed and analyzed the imaging features,and summarized the general data,clinical manifestations,and imaging features of non-infectious granulomas in the lung.Results 72 cases were multiple lesions.Sarcoidosis was distributed along the lymphatic tract and enlargement of hilar and mediastinal lymph nodes was observed.Wegener granuloma was distributed along the airway or under the pleura,and the lesions were di⁃verse in shape.The focus of subacute allergic pneumonia showed ground glass density or lobular central nodule changes,and tree bud sign changes were seen in some cases.Lymphoid granulomatosis was distributed along the airway or under the pleura,and more than half of the cases can be seen the halo sign.Necrotizing nodular granulomatosis was mainly distributed under the pleura,and the focus boundary was clear.Most cases of rheumatoid pulmonary nodules had pulmonary cavity,satellite focus and interstitial changes.Conclusion The comprehensive analysis and judgment combined with clinical and imaging characteristics are beneficial to the diagnosis and differential diagnosis of non-infectious granulomatous lung disease.

关 键 词：结节病 韦格纳肉芽肿 亚急性过敏性肺炎 体层摄影术 X线计算机 

分 类 号：R563[医药卫生—呼吸系统] R814.42[医药卫生—内科学]