胸膜型肺癌的CT表现及误诊分析

目的总结胸膜型肺癌的CT表现特征及其误诊原因，以提高诊断水平。方法回顾2010年1月一2013年12月经术后病理证实的8例胸膜型肺癌患者的CT资料，就病变部位、形态、大小、密度、增强特点、病变毗邻结构以及有无淋巴结肿大、胸腔积液等问题进行分析讨论。结果8例胸膜型肺癌患者中，左侧6例，右侧2例；结节状3例，不规则肿块状5例；密度较均匀6例，病灶不规则稍低密度2例；邻近肋骨破坏4例；胸腔积液6例；纵隔淋巴结肿大5例，其中l例左肺门、左锁骨上区及左侧腋窝多发淋巴结转移；所有8例均为中度强化。结论胸膜型肺癌在CT增强检查中均有一定特征性表现，仔细分析其CT特征表现，并结合临床症状、胸水细胞学检查等资料可作出定性诊断，减少误诊。

The CT Characteristics of Pleural Lung Cancer and Misdiagnosis Analysis

Objective To discuss the CT characteristics of pleural lung cancer, and analyze the reason for misdiagnosis. Methods The CT data of 8 patients with pleural lung cancer confirmed by postoperative pathology and treated in Renshou People＇s Hospital and Fist Affiliated Hospital of Chongqing Medical University between January 2010 and December 2013 were retrospectively analyzed. Results Among the 8 eases of pleural lung cancer, 6 occurred on the left and 2 on the right; there were 3 nodular and 5 irregular masses; 6 had uniform density and 2 had irregular focus and relatively lower density; 4 had osteolytic destruction of adjacent ribs; 6 had pleural effusion; and 5 had mediastinal lymph nodes enlargement, in which 1 had multiple lymph node metastasis of left lung hilum, left supraclavicular region and left axillary. All the 8 cases were enhanced moderately. Confusions Pleural lung cancer has certain featured manifestations on CT. Analyzing the features carefully, considering clinical symptoms, and cytological examination of hydrothorax can reduce the incidence of misdiagnosis.