158例肺癌性淋巴管炎的CT诊断

目的总结肺癌性淋巴管炎的CT表现,提高对该病的认识和诊断准确率。方法收集经高分辨率CT检查并病理证实的肺内癌性淋巴管炎患者158例,回顾分析其CT表现。结果全部病例均表现为不规则小叶间隔增厚,小叶间隔上常可见小结节影;支气管血管束不规则增厚,可呈串珠状或结节状阴影;小叶中心结构的增厚可造成次级肺小叶中心的蜘蛛样改变;斜裂增厚,常呈不规则结节性增厚;胸膜增厚及胸腔积液。小叶间隔不规则增厚143例,右肺93例,左肺43例,两肺22例,胸腔积液98例,肺门、纵隔淋巴结增大28例,肺内多发小结节5例。结论癌性淋巴管炎的CT表现具有一定的特征性表现,但需要与弥漫性线网状影的其他疾病鉴别,如结节病、间质性肺水肿等。

CT disagnosis of pulmonary lymphangitic carcinomatosis (report of 158 cases)

Objective To summarize the CT characteristics of pulmonary lymphangitic carcinomatosis.Methods High-resolution CT was performed in 158 patients with histologically proved pulmonary lymphangitic carcinomatosis.Retrospective analysis of the CT.Results All cases showed irregular interlobular septal thickening,the small nodules were often seen on the interlobular septum.Irregular thickening of bronchovascular bundles with beads or nodules was showed.The centrilobular structure could cause central spider-like changes in secondary pulmonary lobules.Major fissure presented irregular nodular thickening with pleural effusion.Interlobular septal thickening was seen in 143 cases,93 lesions were in the right lung,43 lesions in the left lung,22 cases in two lungs,pleural effusion in 98 cases,hilar and mediastinal lymph node enlargement in 28 cases,pulmonary nodules in 5 cases.Conclusion Pulmonary lymphangitic carcinomatosis can show certain characteristic featureson CT,but the need to diffuse reticular shadow line identificcdion of other diseases,such as sarcoidosis,interstitial pulmonary edema.