| 误诊为肺癌的肺结核结节或肿块的CT表现及原因分析 |
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| 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. |
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| 作者姓名： | 陈茵茵 陈伟棠 陈颖峰 |
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| 作者单位： | 广东省台山市人民医院放射科,广东台山,529200 |
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| 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。
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| 关 键 词： | 肺 肺结核 体层摄影术 X线计算机 |
CT Findings and Cause Analysis of Tuberculosis Nodules or Masses Misdiagnosed as Lung Cancer |
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| CHEN Yin-yin,CHEN Wei-tang,CHEN Ying-feng.CT Findings and Cause Analysis of Tuberculosis Nodules or Masses Misdiagnosed as Lung Cancer[J].Computerized Tomography Theory and Applications,2012,21(2):297-303. |
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| Authors: | CHEN Yin-yin CHEN Wei-tang CHEN Ying-feng |
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| Institution: | (Department of Radiology,Taishan People’s Hospital,Taishan 529200,China) |
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| 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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| Keywords: | lung tuberculosis tomography X-ray computed |
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