CT及病理特殊染色在肺隐球菌病诊断中的应用  

CT Imaging and Special Immunofluorescence Staining in the Diagnosis of Pulmonary Cryptococcosis

作　　者：欧幼宽[1] 杨元锰 Ou Youkuan;Yang Yuanmeng(Department of Imaging,Jinjiang City Hospital,Fujian Sixth People's Hospital,Jinjiang,Fujian 362200)

机构地区：[1]福建晋江市医院(上海市第六人民医院福建医院)影像科,福建晋江362200

出　　处：《现代医用影像学》2024年第10期1829-1833,共5页Modern Medical Imageology

摘　　要：目的:通过对肺隐球菌病的临床表现、CT影像学特点及病理特征分析,提高对本病的诊断准确性。方法:回顾性分析经病理证实的57例肺隐球菌病患者的临床、影像及病理学资料。结果:57例患者中,单发结节或团块24例,多发结节或团块30例,呈片状分布3例;53例病灶位于胸膜下,4例远离胸膜;病灶边界清楚者13例,边界不清者44例;45例有分叶征,37例有毛刺征,33例有晕征,12例有支气管征,10例有空洞征,1例明显钙化。单发病灶与多发病灶的大小、晕征、支气管征差异有统计学意义,病灶边界与分叶征、毛刺征、晕征呈负相关,病灶边界与大小呈正相关。结论:肺隐球菌病临床诊断困难,CT影像结合病理特殊染色有助于定性诊断。Objective:To improve the diagnosis of pulmonary cryptococcosis through analysing the clinical manifestations,CT imaging features and pathological features.Methords:Retrospectively analyzed the clinical,CT findings and pathological features of 57 cases of pathologically confirmed of pulmonary cryptococcosis.Results:Of the 57 patients,24 were consisted single nodules/masses,30 were multiple of nodules/masses and and 3 were flakes.53 cases were located subpleura and 4 cases were far away from pleura.13 cases had clear boundary and 44 cases had unclear boundary.45 cases had lobulation sign,37 of spicule sign,33 of halo sign,12 of bronchial sign,10 of pulmonary cavity and 1 case of obvious calcification.The size,halo sign and bronchial sign were significant difference between single and mutiple nodules/masses.The boundary was positively related to the size,but negative related to the lobulation,spicule and halo sign.Conclusions:The clinical symptoms of pulmonary cryptococcosis are mild and dfficult to diagnose.CT imaging combined with pathological immunohistochemical analysis is helpful for the qualitative diagnosis of pulmonary cryptococcosis.

关 键 词：隐球菌病 结节 肿块 病理 PAS染色 六胺银染色 

分 类 号：R73[医药卫生—肿瘤]