儿童肺朗格罕氏细胞组织细胞增生症的高分辨率CT特征分析  

Pediatric Lung Langerhan Cell Histiocytic Hyperplasia High-resolution CT Feature Analysis

作　　者：张鹏 侯欣 ZHANG Peng;HOU Xin(Department of Radiology,Xi'an Children's Hospital,Xi'an 710003,Shaanxi Province,China)

机构地区：[1]西安市儿童医院放射科,陕西西安710003

出　　处：《中国CT和MRI杂志》2024年第2期77-78,共2页Chinese Journal of CT and MRI

基　　金：西安市卫生健康委员会面上培育项目(2021ms15)。

摘　　要：目的探讨儿童肺朗格罕氏细胞组织细胞增生症不同阶段的高分辨率CT特征。方法回顾性分析西安市儿童医院2018年10月-2021年11月25例经手术病理活检或免疫组化证实的PLCH的HRCT影像资料,对其HRCT特征进行分析。结果早期双肺中下野肺实质周围广泛弥漫性间质改变、网状和星状结节。结节病灶逐渐形成空洞,呈多发气囊影,其大小和壁(多小于1mm)厚薄均不一,上肺野多见。囊腔与结节同时存在,其中部分相邻囊疱且常融合形态多样。病变晚期患者,双肺呈网状改变、瘢痕状纤维化及蜂窝。结论儿童肺部朗格罕氏细胞组织细胞增生症的各个时期在HRCT上具有一定的特征性(双肺小叶中央或细支气管周围有双侧对称的弥漫性分布的网状星芒状结节影,多发囊泡影),HRCT影像学检查有助于对PLCH的认识和诊断,降低该病的误诊率和漏诊率。Objective To investigate the characteristics of high-resolution CT(HRCT)in pulmonary Langrare cell histiocytosis(PLCH).Methods The HRCT imaging data of 25 cases of PLCH confirmed by surgical pathology biopsy or immunohistochemistry were retrospective and analyzed from October 2018 to November 2021,and their HRCT characteristics were analyzed.Results Extensive diffuse interstitial changes around the parenchyma in the middle and lower field in both lungs early on;Diffuse reticular and stellate nodules,Scattered or symmetrically distributed in both lungs.Low-density circular or ovoid balloon shadow is seen in the cavity of the nodule,Different size and wall(less than 1mm),Upper lung field is more common.The cystic cavity was simultaneously with the nodule,Some of the adjacent vesicles are often fused with various forms.Some patients may develop spontaneous pneumothorax,The occurrence of mediastinal gas,hepatosplenomegaly,Osteolytic destruction of the thorax.Patients with advanced lesions,Pulmonary fibrosis with a stellate scar was seen in both lungs,Honeycomb and thick network shading changes.Conclusion Pediatric pulmonary Langerhhan cell histiocytosis is characteristic on HRCT,Bilaterally symmetrical diffuse distribution of network star nodules in the central or around the bronchioles of both lungs,The appearance of ground glass density,HRCT imaging examination contributes to the recognition and diagnosis of PLCH,Reduce the rate of misdiagnosis and missed diagnosis of the disease.

关 键 词：儿童 肺朗格罕氏细胞组织细胞增生症 高分辨率CT 

分 类 号：R739.45[医药卫生—肿瘤]