肺结节病的临床与影像研究

结节病是一种多器官受累的系统性疾病,以肺和胸部淋巴结受累最常见。其临床表现多样,缺乏特异性。病理表现为淋巴细胞、单核-巨噬细胞集聚,以及非干酪样坏死性上皮细胞肉芽肿形成。影像检查方法常为多层螺旋CT及PET/CT。仅依靠临床表现,肺结节病的诊断准确度为33%~42%,如辅以胸部X线检查可以提高至52%~76%,而结合高分辨力CT则能达到78%~80%。结节病诊断十分困难,且易误诊误治,因此明确诊断需要临床、病理及影像方法的结合。

Clinical and imaging features of pulmonary sarcoidosis

Sarcoidosis is a systemic disease than can involve multiple organs. Pulmonary sarcoidosis frequently involves the lung and chest lymph nodes. Its clinical manifestation varies greatly and lacks specificity. The pathological features of pulmonary sarcoidosis include aggregation of lymphocytes, monocytes, and macrophages, as well as the formation of noncaseating granulomas. The most commonly used imaging methods are computed tomography (CT) and PET/CT. The diagnostic accuracy of pulmonary sarcoidosis according to clinical symptoms is only 33%~42%, which can be increased to 52%~76% using chest X-ray, and to 78%~80% using high resolution CT. However, prompt diagnosis of pulmonary sarcoidosis is still a great challenge and requires the use of multiple approaches including clinical examination, pathology, and imaging.