ISSN 1004-4140
CN 11-3017/P
陈茵茵, 陈伟棠, 陈颖峰. 误诊为肺癌的肺结核结节或肿块的CT表现及原因分析[J]. CT理论与应用研究, 2012, 21(2): 297-303.
引用本文: 陈茵茵, 陈伟棠, 陈颖峰. 误诊为肺癌的肺结核结节或肿块的CT表现及原因分析[J]. CT理论与应用研究, 2012, 21(2): 297-303.
CHEN Yin-yin, CHEN Wei-tang, CHEN Ying-feng. CT Findings and Cause Analysis of Tuberculosis Nodules or Masses Misdiagnosed as Lung Cancer[J]. CT Theory and Applications, 2012, 21(2): 297-303.
Citation: CHEN Yin-yin, CHEN Wei-tang, CHEN Ying-feng. CT Findings and Cause Analysis of Tuberculosis Nodules or Masses Misdiagnosed as Lung Cancer[J]. CT Theory and Applications, 2012, 21(2): 297-303.

误诊为肺癌的肺结核结节或肿块的CT表现及原因分析

CT Findings and Cause Analysis of Tuberculosis Nodules or Masses Misdiagnosed as Lung Cancer

  • 摘要: 目的:探讨误诊为肺癌的肺结核结节或肿块的CT表现并分析其原因。方法:收集CT误诊为肺癌的40例病灶直径≥1cm的肺结核结节或肿块。回顾性分析病灶的形状、内部特征、强化特点、边缘、邻近肺组织改变及淋巴结并分析误诊原因。结果:①病灶形状及部位,类圆形22例,分叶状10例,不规则8例,上叶18例,下叶12例,中叶10例,②内部特征,密度均匀28例,空洞3例,钙化7例,空洞伴钙化2例,③病灶强化特点,中度欠均匀强化18例,中度均匀强化5例,轻度欠均匀强化6例,无明显强化11例,④边缘特征及邻近组织改变,边缘不光整40例,边界模糊12例,毛刺征18例,卫星灶40例,胸膜增厚及粘连11例,胸膜凹陷征3例,引流支气管管壁增厚5例,⑤肺门及纵隔淋巴结,淋巴结肿大31例,肿大淋巴结均匀强化21例,环形强化4例,无明显强化6例。结论:误诊为肺癌的肺结核结节或肿块的CT表现不典型,结节或肿块周围的卫星灶提示肺结核的可能,但需要组织活检才能明确诊断。

     

    Abstract: Objective:To investigate CT findings of tuberculosis nodules or masses misdiagnosed as lung cancer and analyze their causes.Methods:40 patients with tuberculosis lesions≥1cm in diameter were misdiagnosed as lung cancer on CT.The shape,internal features,enhanced features,margin,adjacent lymph nodes and lung tissue changes were analyzed retrospectively.The causes of misdiagnosis were also analyzed.Results:(1)The shape and location of the lesion:oval in 22 cases,lobulated in 10 cases,irregular in 8 cases.18 cases in upper lobe,12 cases in lower lobe,10 cases in middle lobe.(2)Internal features:inhomogeneous density in 28 cases,cavitation in 3 cases,calcification in 7 cases,cavitations with calcification in 2 cases.(3)Lesion enhancement characteristics: moderate inhomogeneous enhancement in 18 cases,moderate homogeneous enhancement in 5 cases,slightly inhomogeneous enhancement in 6 cases,no enhancement in 11 cases.(4)Marginal features and adjacent tissue changes:irregular margin in 40 cases,12 cases of ill-defined margin,spicule sign in 18 cases,satellite lesions in 40 cases,pleural thickening and adhesions in 11 cases,pleural indentation in 3 cases,drainage of the bronchial wall by thickness in 5 cases.(5)Hilar and mediastinal lymph nodes:Lymph nodes enlargement in 31 cases. Lymph nodes homogeneous enhancement in 21 cases,ring enhancement in 4 cases,no enhancement in 6 cases. Conclusion:CT findings of tuberculosis nodules or masses misdiagnosed as lung cancer were not typical.Nodules or masses with satellite lesions may be suggestive of tuberculosis,but biopsy to confirm the diagnosis was necessary.

     

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