多层螺旋CT诊断肺小腺癌初探

目的：探讨多层螺旋CT对肺小腺癌的诊断价值。方法：14例患者行多层螺旋CT薄层容积扫描,经工作站后处理分别获得多层面重建（MPR）,最小密度投影（MinIP)等重建图像,病变的影像特征与临床病理对照。结果：14例肺小腺癌的密度改变有2种形式：5例支气管肺泡癌中4例可见磨玻璃密度,9例腺癌皆为实质性密度,3例支气管肺泡癌表现为空气支气管征与磨玻璃混合存在。多层螺旋CT薄层扫描所获得的MPR图像在14个病例中均清晰显示叶间胸膜,并可对叶间胸膜的牵拉和破坏做出准确判断,10例MinIP可看到5－6级支气管,使周围型小腺癌内空气支气管征的观察更直观。结论：多层螺旋CT薄层扫描及后处理图像对小腺癌的诊断是一种具有很大价值的检查手段。     

肺腺鳞癌的螺旋CT表现与病理对照研究

目的　探讨肺腺鳞癌的螺旋CT表现与组织病理所见的相关性。资料与方法　搜集经手术病理证实的肺腺鳞癌 15例 ,男 10例 ,女 5例 ,年龄 42～ 73岁 ,平均 6 0 .8岁。均采用螺旋CT扫描。结合组织病理所见 ,观察和评价肿瘤内部结构、密度分布、边缘特征及周围肺组织改变等CT表现。结果　 15例肺腺鳞癌中 ,周围型 12例 ,中央型 3例 ;肿块直径为 3.8± 1.1cm ;均匀密度肿块 2例 (13%) ,不均匀密度肿块 13例 (87%) ;常见CT征象包括分叶征 14例 (93%) ,胸膜凹陷征 12例 (80 %) ,肿块内坏死 11例 (73%) ,血管集束征 10例 (6 7%)和毛刺征 8例 (5 3%)。不常见征象包括空洞和支气管气相各 1例。病理上肿瘤呈灰白色 ,边界清楚 ,分叶 ,肿瘤呈实体性生长 ,腺癌与鳞癌成分并存。结论　肺腺鳞癌以周围型多见 ,螺旋CT像上呈软组织肿块 ,常伴有坏死 ,这与肿瘤呈实体性生长的组织病理学特征有关。     

肺局灶性磨玻璃密度结节的多层螺旋CT诊断

目的探讨肺局灶性磨玻璃密度结节(fGGO)的多层螺旋CT(MSCT)特征与病灶良恶性的相关性。资料与方法回顾性分析36例fGGO患者的影像学资料,包括8例炎症,18例肺泡癌,8例腺癌,2例非典型腺瘤样增生,评价病灶形态学特征及内部结构与良恶性的相关性。结果 8例炎症中7例呈斑片状;肺不典型腺瘤样增生(AAH)均为圆形或类圆形;细支气管肺泡癌(BAC)和腺癌主要呈圆形、不规则形及分叶征。11例BAC和腺癌边缘毛糙或伴毛刺征,16例边缘清晰、光整。15例胸膜凹陷征,均见于BAC和腺癌;16例胸膜增厚,3例见于炎症,13例见于BAC和腺癌。6例炎症和2例AAH为纯GGO,18例BAC和8例腺癌为混杂GGO。结论 fGGO的CT征象与病灶病理类型具有较高的相关性,对于提高其诊断准确率具有重要的临床价值。     

磨玻璃密度小肺癌CT表现与病理类型相关性研究

目的：探讨磨玻璃密度（GCO）小肺癌的CT表现与病理类型相关性。方法：搜集43例（45个）表现为纯磨玻璃密度（pGGO）或混合磨玻璃密度（mGGO）的周围型小肺癌,根据GGO占整个病灶比例的不同分三型,分别与病理对照。并有12个小肺癌术前行中长期动态观察。结果：I型（GGO成分占91％-100％）11个,病理均为细支气管肺泡癌（BAC）;II型（GGO成分占51％。90％）21个,BAC11,BAC伴高分化腺癌4个,高分化腺癌4个,中分化腺癌2个;Ⅲ型（GGO成分占≤50％）13个,BAC3个,中分化腺癌5个,低分化腺癌3个,低分化鳞癌2个;通过三型间比较发现GGO所占比例越高,小肺癌的病理分化越好,GGO成分占≥50％时,病理多数为BAC（22／32）;同时对部分小肺癌术前中长期动态观察及术后随访,发现肿瘤生长缓慢、预后良好。结论：局限性GGO不仅是周围型肺癌的重要征象之一,而且通过半定量分析GGO所占比例的多少,能一定程度上预测其病理类型、分化程度、倍增时间及预后。     

不典型肺结节的螺旋CT与临床病理诊断的对比分析

目的：探讨螺旋CT在不典型肺结节诊断中的应用价值。材料和方法：回顾性分析36例经手术（33例）、穿刺（7例）确诊为不典型肺结节的CT图像和临床病理学资料。结果：CT表现：浅分叶征（17／36）、形态不规则（25／36）、长毛刺征（5／36）、空气支气管征（1／36）、空泡征（1／36）、部分非实性结节（3／36）和实性结节（33／36）。螺旋CT拟诊肺癌19例、肺结核瘤11例和肺炎性假瘤6例。病理证实：肺癌15例（腺癌8例、鳞癌4例、肺泡癌2例和类癌1例）、肺结核瘤15例和肺炎性假瘤6例。诊断符合率：肺癌为10／15、肺结核瘤为9／15和肺炎性假瘤为1／6。结论：螺旋CT对不典型肺结节的定性诊断较局限，常需穿刺活检或手术病理确诊。但其对不典型肺内结节具有很好的定位、密度分辨、形态描述和复查对比价值。     

肺腺癌浸润前病变的CT诊断

【摘要】目的：探讨肺腺癌浸润前病变的CT表现。方法：回顾性分析2011年3月－2016年12月经手术病理证实的45例肺腺癌浸润前病变患者的临床和CT资料,其中不典型腺瘤样增生（AAH）10例、原位癌（AIS）35例,主要分析指标包括病灶分布、大小、密度、分叶征、毛刺征、空泡征、充气支气管征、肿瘤微血管成像征和胸膜凹陷征。结果：35例表现为纯磨玻璃密度结节、10例为部分实性成分磨玻璃密度结节;AAH组和AIS组中病灶直径分别为（10.15±3.72）和（11.73±4.58）mm,平均CT值分别为（－514±70.66）和（－477.2±168.08）HU,两组间差异均无统计学意义（P>0.05）。CT征象中以肿瘤微血管成像征最多见（出现率为68.9％）,其次是分叶征、空泡征（均为26.7％）,充气支气管征最少见（4.4％）;两组间各征象的差异均无统计学意义（P>0.05）。结论：肺腺癌浸润前病变的CT征象中肿瘤微血管成像征具有一定特异性,CT形态学征象并不能准确鉴别不典型腺瘤样增生和原位癌。     

恶性胸腺瘤的CT与MRI诊断

目的：分析侵袭性胸腺瘤及胸腺癌的CT及MRI表现，探讨其鉴别诊断要点。方法：复习经病理组织学证实的18例侵袭性胸腺瘤及9例胸腺癌的CT、MRI所见，重点观察肿瘤的大小、密度、边缘改变，对周围纵隔结构的侵犯。结果：18例侵袭性胸腺瘤、9例胸腺癌CT、MRI均表现为前纵隔不规则软组织肿块。前者肿瘤直径大于8cm者15例（83％），病灶内密度及信号不均匀12例。心血管受侵16例，后者肿块直径在8cm以上者7例（77.8％),肿块内密度及信号不均6例，心知管受累8例，纵隔肺门淋巴结转移1例，肺内转移3例，双侧肾上腺及肝脏转移1例。结论：虽然侵袭性胸腺瘤和胸腺癌的影像学表现相似，但胸腺癌更具有侵袭性，胸外转移常见，病理组织学检查有助于两者的鉴别。     

原发性肺淋巴瘤CT特征分析

【摘要】目的：探讨原发性肺淋巴瘤（PPL）的CT表现,提高CT对该病的诊断准确性。方法：回顾性分析本院经病理证实的22例PPL患者的CT资料,主要观察内容包括肿瘤的发病部位、形态、数目、密度、特殊征象及强化程度等。结果：22例中结节或肿块型13例,肺炎或肺泡型7例,混合型2例。肿瘤密度较均匀19例,呈中度－明显均匀强化19例。11例出现空气支气管征,15例出现血管造影征,8例出现跨叶征, 4例出现扇形征,4例出现空泡征。5例可见肺门及纵隔淋巴结肿大。结论：原发性肺淋巴瘤的CT表现缺乏特异性,确诊需依赖组织病理学检查。     

肺微浸润型腺癌与原位腺癌的HRCT表现及鉴别诊断

目的探讨同表现为磨玻璃密度结节(GGO)的微浸润型肺腺癌的高分辨率CT(HRCT)影像特点及与原位腺癌的鉴别诊断,以应对肺小结节的临床处置。方法经病理证实的肺原位腺癌或微浸润型肺腺癌患者72例(均为周围型、直径2.5cm),术前均行常规HRCT扫描,经多方位薄层重建,观察病灶的HRCT表现。结果 72例患者中68例均为单发结节,4例为多发(两个)。其中纯磨玻璃结节47个,混杂磨玻璃样结节29个,病灶直径为0.6~2.4cm,平均(1.5±0.9)cm;量化分型中Ⅰ型0例、Ⅱ型3例、Ⅲ型10例,Ⅳ型16例,Ⅴ型47例;混杂GGO边缘清晰24个,分叶4个,毛刺征2个;胸膜凹陷征3个;空气-细支气管扩张征1个;支气管狭窄、截断征0个,血管集束征1个。结论 HRCT检查发现GGO影时,特别是纯GGO,大小在0.6~1.0cm之间,实性成份小于25%(量化分型较高),病灶边缘清晰,不伴有分叶征、胸膜凹陷及毛刺征时,应考虑原位腺癌,可以随访复查,余均要高度怀疑恶性病变(微浸润型肺腺癌),建议尽早择期手术切除后病理检查。     

孤立结节周围型肺癌的多层螺旋CT诊断

目的：探讨多层螺旋CT对孤立结节周围型肺癌的诊断价值。方法回顾分析我院2009年2月至2014年4月46例经手术、穿刺活检病理证实,直径≤3 cm的肺内孤立结节周围型肺癌的多层螺旋CT征象进行分析和总结。结果46例肺内孤立结节周围型肺癌中,腺癌25例,鳞癌11例,小细胞癌9例,未分型癌1例。多层螺旋CT征象：分叶征36例（78％）;毛刺征28例（61％）,短毛刺21例,长毛刺7例;棘状突起13例（28．3％）;空泡征9例（20％）;胸膜凹陷征16例（35％）;血管集束征12例（26％）。增强扫描11例,增强幅度42-65 Hu。结论多层螺旋CT三维重组,可以发现更多有诊断价值的CT征象,对孤立结节周围型肺癌的诊断与鉴别诊断具有较高的临床价值。     

High-resolution CT analysis of small peripheral lung adenocarcinomas revealed on screening helical CT

OBJECTIVE: The purpose of this study was to determine the correlation between high-resolution CT morphologic features of small peripheral lung adenocarcinomas and tumor growth patterns. MATERIALS AND METHODS: We examined high-resolution CT morphologic features of 59 small, surgically resected peripheral lung adenocarcinomas (diameter, 6-20 mm) that were detected on screening for lung cancer using low-dose helical CT. Among these adenocarcinomas, 14 (24%) were visible and 45 (76%) were invisible on conventional chest radiography. The correlation between high-resolution CT morphologic features and tumor growth patterns was analyzed. RESULTS: Sixteen (94%) of 17 type A (Noguchi's classification) adenocarcinomas appeared as nodules of pure ground-glass attenuation (high-resolution CT type I). Ten (71%) of 14 type B tumors appeared as heterogeneous, low-attenuation nodules (type II). Seven (29%) of 24 type C tumors appeared as nodules with ground-glass attenuation in the periphery and a high-density central zone (type III), and 12 (50%) of 24 type C tumors appeared as homogeneous nodules with soft-tissue density (type IV). Among tumors with a replacement growth pattern, the size and CT values of type C tumors were larger than those of type A or type B tumors (p < 0.05), whereas the percentage of ground-glass attenuation and retained air space in type C tumors was smaller than those in type A or type B tumors (p < 0.01). All (100%) four type D tumors appeared to be homogeneous nodules with soft-tissue density (type IV). CONCLUSION: Small peripheral lung adenocarcinomas shown on CT exhibit four high-resolution CT patterns that corresponded to the histopathologic findings of different tumor growth patterns.     

Radiographic features of invasive lobular carcinoma of the breast

PURPOSE: To evaluate the radiographic features of invasive lobular carcinoma of the breast. METHODS: We evaluated the radiographic features of 61 cases of histopathologically documented invasive lobular carcinoma. Mammography was performed in all cases. In seven of 61 cases, helical CT with contrast medium was also carried out. Mammographic findings were analyzed to determine true-positive and false-negative rates for the detection of neoplasm. Further, the diameter of the tumor as determined on mammography and helical CT was noted for comparison with the pathologic size. RESULTS: Mammographic features were divided into six types: spiculated mass (38%), indistinct mass (5%), obscured mass (23%), asymmetric opacity (16%), architectural distortion (16%), and no findings (2%). Microcalcifications were present in 12 cases (20%).The overall sensitivity rate was 59%. However, 20 (56%) of 36 cases that were diagnosed as detectable on mammography were underestimated in terms of tumor size compared with the histopathologic findings. Four cases examined by helical CT with contrast medium were compared with the histopathologic findings in terms of extent of the lesion. In three cases, helical CT was more precise than mammography, but the histopathologic findings showed lesions beyond the region evaluated by helical CT. CONCLUSION: Invasive lobular carcinoma is difficult to detect radiographically, and the extent of the lesion tends to be underestimated.     

Persistent pulmonary nodular ground-glass opacity at thin-section CT: histopathologic comparisons

PURPOSE: To retrospectively compare pure pulmonary ground-glass opacity (GGO) nodules observed on thin-section computed tomography (CT) images with histopathologic findings. MATERIALS AND METHODS: The institutional review board approved this study and waived informed consent. Histopathologic specimens were obtained from 53 GGO nodules in 49 patients. CT scans were assessed in terms of nodule size, shape, contour, internal characteristics, and the presence of a pleural tag. The findings obtained were compared with histopathologic results. Differences in thin-section CT findings according to histopathologic diagnoses were analyzed by using the Kruskal-Wallis test or Fisher exact test. RESULTS: Of 53 nodules in 49 patients (20 men, 29 women; mean age, 54 years; range, 29-78 years), 40 (75%) proved to be broncholoalveolar cell carcinoma (BAC) (n=36) or adenocarcinoma with predominant BAC component (n=4), three (6%) atypical adenomatous hyperplasia, and 10 (19%) nonspecific fibrosis or organizing pneumonia. No significant differences in morphologic findings on thin-section CT scans were found among the three diseases (all P>0.05). A polygonal shape (25%, 10 of 40 nodules) and a lobulated or spiculated margin (45%, 18 of 40) in BAC or adenocarcinoma with predominant BAC component were caused by interstitial fibrosis or infiltrative tumor growth. A polygonal shape and a lobulated or spiculated margin were observed in two (20%) and three (30%) of 10 nodules, respectively, in organizing pneumonia/fibrosis were caused by granulation tissue aligned in a linear manner in perilobular regions with or without interlobular septal thickening. CONCLUSION: About 75% of persistent pulmonary GGO nodules are attributed to BAC or adenocarcinoma with predominant BAC component, and at thin-section CT, these nodules do not manifest morphologic features that distinguish them from other GGO nodules with different histopathologic diagnoses.     

螺旋CT对胃癌分期的价值

目的评价螺旋CT对胃癌术前分期的应用价值。材料与方法应用水充盈技术对63例胃癌患者行螺旋CT扫描,并与病理对照。结果46例胃癌病灶均明显增强,CT检出率为95.8％,胃癌侵犯深度、淋巴结转移、远处转移分期的准确性分别为70.8％、66.7％、80％。结论应用水充盈技术行螺旋CT扫描对胃癌患者的术前分期有重要价值。     

粟粒型肺结核和粟粒性肺转移瘤的螺旋CT鉴别特征

目的探讨粟粒型肺结核和粟粒性肺转移瘤的螺旋CT表现特征,以提高肺部弥漫性粟粒性病变的影像诊断水平。方法收集经临床证实的34例粟粒型肺结核和54例粟粒性肺转移瘤的螺旋CT资料,观察肺粟粒结节的分布、大小,肺密度,肺门、纵隔淋巴结增大及肺内并发病灶。结果CT图像上,34例粟粒型肺结核中,结节均匀分布28例(28/34,82%),大小一致23例(23/34,68%),密度均匀25例(25/34,74%)以及毛玻璃征26例(26/34,76%)。54例粟粒性肺转移瘤的粟粒结节分布、大小、密度大多不均匀,分别为49例(49/54,91%),39例(39/54,72%),41例(41/54,76%),毛玻璃征(GGO)8例(8/54,15%)。两者在结节分布、大小、密度均匀性和伴毛玻璃征方面均有统计学差异(P<0.05)。肺内其它改变:9例(9/34,26%)结核的肺门和纵隔淋巴结增大,而肺转移瘤有29例(29/54,54%);结核性胸腔积液15例(15/34,44%),肺转移瘤30例(30/54,56%);心包积液中,结核8例(8/34,24%),肺转移瘤20例(20/54,37%)。结论血行播散型肺结核和粟粒性肺转移瘤在结节分布、大小和密度等方面螺旋CT表现特征明显不同,这些特征与它们的血行播散途径和相应的病理解剖改变有密切关系。     

Peripheral lung adenocarcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival

PURPOSE: To evaluate the prognostic importance of thin-section computed tomographic (CT) findings of peripheral lung adenocarcinomas. MATERIALS AND METHODS: The subjects were 127 patients with adenocarcinomas smaller than 3 cm in largest diameter who underwent at least a lobectomy with hilar and mediastinal lymphadenectomy. The margin characteristics of nodules and the extent of ground-glass opacity (GGO) within the nodules at preoperative thin-section CT were analyzed retrospectively. Regional lymph node metastasis (LNM) and vessel invasion (VI) were histologically examined in surgical specimens. Survival curves were calculated according to the Kaplan-Meier method. RESULTS: The frequencies of LNM (4% [1 of 24]) and VI (13% [three of 24]) in adenocarcinomas with GGO components of more than 50% were significantly lower than those with GGO components of less than 10% (LNM, P <.05; VI, P <.01). The patients with GGO components of more than 50% showed a significantly better prognosis than those with GGO components less than 50% (P <.05). All 17 adenocarcinomas smaller than 2 cm with GGO components of more than 50% were free of LNM and VI, and all these patients are alive without recurrence. Coarse spiculation and thickening of bronchovascular bundles around the tumors were observed more frequently in tumors with LNM or VI than in those without LNM or VI (P <.01). CONCLUSION: Thin-section CT findings of peripheral lung adenocarcinomas correlate well with histologic prognostic factors.     

周围型浸润性肺腺癌EGFR基因突变与CT征象及病理的相关性

目的：探讨周围型浸润性肺腺癌表皮生长因子受体(EGFR)基因突变状态与 CT 征象及病理特征的相关性。方法收集193例经病理证实为周围型浸润性肺腺癌的手术标本,采用扩增阻滞突变系统对所有标本行 EGFR基因突变检测,结合胸部 CT征象及病理资料进行回顾性分析。结果193例中EGFR基因突变率为62.2%(120/193)。在CT征象方面：基因突变组与野生型组于横轴位上肿瘤最大直径(Dmax)分别为(2.52±1.01)cm和(3.11±1.34)cm,差异有统计学意义(P<0.05)。受试者工作特征曲线(ROC)提示Dmax=2.01 cm为判断 EGFR基因突变状态的最佳诊断阈值,敏感度与特异度分别为79%和64%。含磨玻璃密度影(GGO)的肿瘤突变率为78.0%,高于无 GGO 者(56.6%),P<0.05。肿瘤不伴有囊腔样改变者突变率为65.5%,高于伴有囊腔样改变者(40.0%),P<0.05。磨玻璃影/肿瘤直径比(G/T)、分叶征、毛刺征、胸膜凹陷征、血管集束征、空气支气管征、空泡征与EGFR基因突变率无显著相关性(P值均>0.05)。在病理特征方面：组织学亚型中以贴壁生长为主型突变率为77.5%,高于其他亚型(58.2%),P<0.05。以实体生长为主型突变率为26.3%,低于其他亚型(66.1%),P<0.05。无淋巴结转移者突变率为66.9%,高于淋巴结转移者(50.9%),P<0.05。结论在周围型浸润性肺腺癌中,部分CT征象及病理特征对于辅助预测 EGFR基因突变状态具有一定价值。     

磨玻璃密度肺小腺癌病理亚型的Ultra-HRCT分析

目的:探讨直径≤2cm磨玻璃密度(GGO)肺腺癌的超高分辨率CT影像学表现与病理Noguchi分型的相关性.方法:回顾性分析56例表现为单纯磨玻璃密度(pGGO)或混合磨玻璃密度(mGGO)的周围型小肺癌的超高分辨率CT征象,分别与病理Noguchi分型对照.结果:病灶纯磨玻璃密度、分叶征、毛刺、胸膜凹陷、血管集束征/增粗和棘突征在各不同病理亚型中出现比率有显著差异,P值分别为0.001,0.022,0.002,0.022,0.032和0.012.而边缘、空泡、蜂房征在不同病理亚型无显著差异.结论:磨玻璃密度结节的部分形态学征象与病理Noguchi亚型有明显相关性,有助于预测病灶的恶性程度.     

Evolution of peripheral lung adenocarcinomas: CT findings correlated with histology and tumor doubling time

OBJECTIVE: This study was performed to evaluate the evolution of peripheral lung adenocarcinomas using CT findings and histologic classification related to tumor doubling time. MATERIALS AND METHODS: The subjects were 34 patients, each with an adenocarcinoma smaller than 3 cm. All patients underwent chest radiography and 10 of them had previously undergone CT more than 6 months before surgery. Tumor doubling time was estimated by examining sequential radiographs using the method originally described by Schwartz. Tumor growth was also observed by studying the changes on CT in the 10 patients who had previously undergone CT. The histologic classification (types A-F) was evaluated according to the criteria of Noguchi et al. RESULTS: Five (83%) of the six adenocarcinomas with tumor types A or B showed localized ground-glass opacity on high-resolution CT. All six tumors had a tumor doubling time of more than 1 year. Fifteen (71%) of the 21 tumors with type C showed partial ground-glass opacity mixed with localized solid attenuation on high-resolution CT. Ten (48%) of these 21 type C tumors had a tumor doubling time of more than 1 year. In types B and C, the solid component or the development of pleural indentation and vascular convergence increased during observation before surgery. All seven tumors with types D, E, and F showed mostly solid attenuation, and the tumor doubling time was less than 1 year in six (87%) of the seven tumors. CONCLUSION: Two main types of peripheral lung adenocarcinoma exist. The first type appears on CT as a localized ground-glass opacity with slow growth, and the other appears as a solid attenuation with rapid growth.     

Rheumatoid arthritis-related lung diseases: CT findings

PURPOSE: To evaluate computed tomographic (CT) findings of rheumatoid arthritis-related lung disease and categorize findings according to pathologic features. MATERIALS AND METHODS: CT scans obtained in 63 patients (27 men, 36 women; mean age, 61.7 years +/- 11.2 [SD]; range, 28-81 years) with rheumatoid arthritis were assessed. Mean duration of disease was 7.6 years +/- 9.2. Lung parenchymal abnormalities that included airspace consolidation, ground-glass opacity (GGO), reticulation, honeycombing, nodules, bronchiectasis, and air trapping were assessed retrospectively by two chest radiologists. Final decision was reached with consensus of these radiologists and a third radiologist. Patients were classified according to the predominant CT pattern. One of the chest radiologists and a pulmonary pathologist compared CT findings with pathologic findings in 17 patients. Interobserver agreement between the first two radiologists was assessed. Correlation between CT finding extent score and pulmonary function test results was estimated with Spearman rank correlation coefficient. RESULTS: GGO (57 [90%] patients) and reticulation (62 [98%] patients) were the most common CT features. Four major CT patterns were identified: usual interstitial pneumonia (n = 26), nonspecific interstitial pneumonia (n = 19), bronchiolitis (n = 11), and organizing pneumonia (n = 5). Usual interstitial pneumonia and nonspecific interstitial pneumonia CT patterns overlapped; GGO was more extensive in patients with nonspecific interstitial pneumonia CT pattern (P =.028). In 17 patients who underwent biopsy, CT findings reflected pathologic findings. Exceptions were two patients classified with usual interstitial pneumonia at CT but with nonspecific interstitial pneumonia at pathologic analysis; one patient, with nonspecific interstitial pneumonia at CT but desquamative interstitial pneumonia at pathologic analysis; and one patient, with lymphoid interstitial pneumonia at CT but nonspecific interstitial pneumonia at pathologic analysis. CONCLUSION: Rheumatoid arthritis is associated with four CT patterns: usual interstitial pneumonia, nonspecific interstitial pneumonia, bronchiolitis, and organizing pneumonia. The most common CT features of rheumatoid arthritis-related lung disease were GGO and reticulation.