导致胸部结节病初诊困难的原因分析

目的　分析胸部结节病的影像学表现 ,探讨造成结节病初诊困难的原因。资料与方法　回顾性分析 5 7例胸部结节病临床资料及其影像学 (X线平片及CT)表现。其中有 32例初诊为其他疾病 ,但需进一步检查除外结节病。结果　 5 7例均可见胸部淋巴结增大 ,其中 4 2例纵隔、双侧肺门淋巴结均增大 ;8例纵隔、单侧淋巴结增大 ;7例仅见纵隔淋巴结增大。 36例出现肺部病变 (包括 2 6例肺内多发结节 ,8例斑片状阴影 ,2例肺纤维化 ) ;4例胸膜病变。结论　结节病的胸部影像及临床表现缺乏特异性 ,肺部病变及不典型胸部淋巴结增大是导致结节病初诊困难的主要原因

Analysis of Some Reasons that Cause the Preliminary Diagnosis Difficulty in Thoracic Sarcoidosis

Objective To analyze the radiological manifestation of thoracic sarcoidosis and discuss the reasons that cause some cases preliminary diagnosis difficulty.Materials and Methods 57 cases with thoracic sarcoidosis were reviewed retrospectively, including their clinical data and chest radiography, CT. In which 32 cases were preliminarily diagnosed as other diseases, but further examination must be taken to exclude thoracic sarcoidosis.Results Thoracic lymphnodes were enlarged in all cases. 42 cases were presented as mediastinal and bilateral hilar lymph nodes enlargement. 8 cases had mediastinal and unilateral hilar lymph nodes enlargement. 7 cases only had enlarged mediastinal lymph nodes. 36 cases had pulmonary abnormalities, including multiple pulmonary nodes (26 cases), patchy pulmonary shadows (8 cases), pulmonary fibrosis (2 cases). 4 cases had pleural lesions.Conclusion Because lack of speciality with radiological manifestation and clinical findings in thoracic sarcoidosis, pulmonary abnormality and atypical thoracic lymphnodes enlargement are the main reasons that cause preliminary diagnosis difficulty of thoracic sarcoidosis.