实变型细支气管肺泡癌的影像学表现及病理变化

目的探讨实变型细支气管肺泡癌（BAC）的影像学和病理学特点．方法对11例经病理证实的实变型BAC的临床表现、影像学征像及其病理特征进行回顾性分析．结果11例中，单发肺叶实变7例（63．6％），单发肺段实变2例（18．1％），多发肺叶实变2例（18．1％）；实变肺伴血管造影征7例（63．6％）、支气管气像征9例（81．8％）、伴枯树枝征6例（54．5％）；实变肺周见蜂窝肺征9例（81．8％），磨玻璃征7例（63．6％）、多发小结节2例（18．1％）；少量胸水1例（9．1％），肺门淋巴结肿大1例（9．1％）．11例首诊误诊为肺炎．结论临床表现无特异性，肺实变密度低、蜂窝肺征、血管造影征、枯树枝征及多发腺泡结节是实变型BAC的主要CT表现特点；CT引导肺穿刺活检是较理想的确诊手段．

CT Fingdings and Pathologic Basis of Consolidative Bronchioloalveolar Carcinoma

Objective To study the clinical and CT features of consolidative bronchioloalveolar carcinoma （BAC）. Method CT findings of 1 lpatients with consolidative bronchioloalveolar carcinoma proved pathologically were retrospectively analyzed. Results The main CT findings of BAC in 11 cases were consolidation, included single lobar or segmental consolidation （n = 9, 81.8%）, multilobar consolidation （n = 2,18.1%）. Within consolidation demonstrated lower density with angiogram sign （n = 7, 63.6% ） , and air bronchogram （n = 9, 81.8%） with leafless tree sign （n = 6, 54.5%） ; Outside of consolidation showed honeycomb sign （n = 9, 81.8%）, ground glass shadow （n =7, 63.6%）, multinodules （n=2, 18.1%）. The other findings included little pleural effusion （n = 1, 9.1%） , enlarged mediastinal lymph node （n = 1, 9.1% ）. However, 11 cases were first misdiagnosed pneumonia. Conclusions Low density of the consolidation, honeycomb sign, angiogram sign, leafless tree sign and muhiacinar nodules are the main features of consolidative BAC in CT. CT guided fine needle biopsy is a useful method for diagnosis of BAC.