硬化性肺细胞瘤多层螺旋CT表现与误诊分析

目的 探讨硬化性肺细胞瘤（PSP）多层螺旋CT（MSCT）表现,分析误诊原因。方法 对2012年2月至2016年2月安徽医科大学第一附属医院经病理证实的15例PSP 患者 MSCT资料进行回顾性分析,所有患者术前均行MSCT平扫及增强检查。结果 所有患者均为肺内单发病灶,发生于双肺下叶11例,形态呈类圆形或卵圆形11例,形态不规则或边缘呈浅分叶4例,边缘清楚9例,边缘不清6例。病灶最大径平均（3.40±1.21）cm。病灶密度均匀9例,密度不均匀6例。病灶内见钙化5例,无钙化10例。病灶平扫CT值平均（31.36±8.24）HU,增强后CT值增加约（41.94±20.40）HU。病灶见"贴边血管征"9例、"假包膜征"2例及"瘤周磨玻璃密度"2例。4例误诊为周围型肺癌,1例误诊为结核,1例误诊为肺错构瘤。结论 PSP瘤是一种少见肺内良性肿瘤,MSCT表现具有一定特征性,"贴边血管征"假包膜征"瘤周磨玻璃密度"及"空气新月征"等征象有助于治疗前的影像诊断与鉴别。

Multislice CT characteristics of pulmonary sclerosing pneumocytoma and analysis of misdiagnosis

Objective Toinvestigate the multislice CT (MSCT) features of pulmonary sclerosing pneumocytoma and analyzethe misdiagnosed cases. Methods The clinical data of 15 cases with pathologically proven pulmonary sclerosing pneumocytoma were analyzed retrospectively, and all patients underwent plain CT and enhanced CT scan. Results All 15 cases were solitary, 11 cases showed locations in the bilateral lower lobe of two lungs, 11 cases were round or oval, and 4 cases were light lobulated and irregular, 9 cases had smooth margin,and 6 cases showed unclear margin. The mean maximum size of tumors was (3.40±1.21)cm. Ninecases showed homogeneous density and the others were heterogeneity, and five cases contained spotted calcification. The mean CT value in solid mass of unenhanced CT was (31.36±8.24)HU, and it increasedto (41.94±20.40)HU after enhancement CT.The "overlying vessel sign" and "marginal pseudocapsule sign" appeared in nine cases and two cases, and the "halo sign"presented in two cases. Four of misdiagnosed cases were peripheral lung cancer, among which one was hamartoma, and one was tuberculoma. Conclusion Pulmonary sclerosing pneumocytoma is a rare benign lung neoplasm, and the special signs of MSCT imaging features can help the differential diagnosis.