先天性肺囊性腺瘤样畸形的影像表现与病理对照分析  

Comparative analysis of imaging manifestations and pathology in congenital cystic adenomatoid malformation of the lung

作　　者：焦振华 刘连锋 高亭 张粉娟 何源青 秦琛琛 JIAO Zhenhua;LIU Lianfeng;GAO Ting;ZHANG Fenjuan;HE Yuanqing;QIN Chenchen(Imaging Center,Xianyang Central Hospital,Xianyang,Shaanxi Province 712000,China;Department of Pathology,Xianyang Central Hospital,Xianyang,Shaanxi Province 712000,China;Department of Pneumology,Xianyang Central Hospital,Xianyang,Shaanxi Province 712000,China)

机构地区：[1]咸阳市中心医院影像中心,陕西咸阳712000 [2]咸阳市中心医院病理科,陕西咸阳712000 [3]咸阳市中心医院呼吸科,陕西咸阳712000

出　　处：《实用放射学杂志》2024年第9期1425-1428,共4页Journal of Practical Radiology

基　　金：陕西省自然科学基础研究计划项目(S2024-JC-QN-0640)。

摘　　要：目的 探讨先天性肺囊性腺瘤样畸形(CCAM)的影像表现与病理分型的相关性.方法 回顾性分析9例经术后病理证实为CCAM患者的临床及影像学资料,并与其Stocker病理分型进行对照分析.结果 9例患者CT显示囊肿内气体或液体填充,均与其大体病理完全一致.4例大囊型CCAM(囊径>2 cm)的病理结果符合Stocker Ⅰ型,CT表现为占据胸腔的单囊或多个囊腔,囊内以气体或液体为主,2例伴占位效应和受累肺叶扩张,2例病灶周围局部密度减低.其病理特征为单个或多个具有厚壁的大囊肿,镜下可见囊腔内衬假复层纤毛柱状上皮.5例小囊型CCAM(囊径<2 cm)的病理结果符合Stocker Ⅱ型,CT表现为局限于单个肺叶内的多发薄壁蜂窝状囊肿,均未见显著的占位效应或受累肺叶扩张.病理以多发小囊肿伴间隔为特点,镜下可见囊肿内覆纤毛柱状或立方上皮.结论 CCAM具有特异的影像学表现,CT不仅能精确显示病变的分布范围及其形态特征,还能准确反映其内部组织学特性,各型CCAM的CT表现与其病理分型之间存在显著的相关性.Objective To investigate the correlation between the imaging manifestations and pathological classification of congeni-tal cystic adenomatoid malformation of the lung(CCAM).Methods A retrospective analysis was conducted on the clinical and radiologic data of nine patients with pathologically confirmed CCAM,and all data were compared with Stocker pathological classification,respec-tively.Results The CT images of all nine patients demonstrated cysts filled with either gas or fluid,which corresponded exactly with their gross pathological outcomes.Four cases of large cystic CCAM(cyst diameter exceeding 2 cm)were consistent with Stocker type Ⅰ.CT findings showed single or multiple capsular cavities occupying the thoracic cavity,with gas or fluid mainly in the cyst.Two cases exhibited mass effect and expansion of the involved lung lobes,while two cases showed localized decreased density around the lesion.The pathological features of these large cystic CCAM included single or multiple thick-walled cysts,with pseudostratified ciliated colum-nar epithelium lining the cyst lumen observed under microscopy.The other five cases of small cystic CCAM(cyst diameter less than 2 cm)matched Stocker type Ⅱ.CT findings showed multiple thin-walled cellular cysts confined to a single lung lobe,and none of these patients had significant mass effect or expansion of the involved lung lobes.Pathologically,these cases were characterized by multiple small cysts with septa,and the cysts were primarily lined with ciliated columnar or cuboidal epithelium upon microscopy.Conclusion CT imaging of CCAM has specific manifestations,with accurately displaying the distribution range and morphological characteristics of the lesions and reflecting the internal histological characteristics.There is a significant correlation between the CT manifestations of CCAM and their pathological classification.

关 键 词：囊性腺瘤样畸形 肺 先天性 计算机体层成像 病理学 

分 类 号：R563[医药卫生—呼吸系统] R814.42[医药卫生—内科学] R446.8[医药卫生—临床医学]