马华16例细支气管肺泡细胞癌影像特点及误诊原因分析MicrosoftWord文档.doc

16例肺炎型细支气管肺泡细胞癌影像特点及误诊原因分析 马华 江苏省淮安市肿瘤医院 影像科 223200 [摘要] 目的：总结16例肺炎型细支气管肺泡细胞癌（BAC）影像特点及分析其误诊原因，为不断提高对本病认知和诊断能力。方法：对16例肺炎BAC患者误诊的影像及临床资料进行回顾性分析。结果：16例肺炎型BAC患者误诊为大叶性肺炎9例，其中5例考虑军团菌感染的可能；肺结核2例、慢性支气管及其周围炎2例、转移性肿瘤2例、周围型孤立性小片状肺炎1例。结论：肺炎型BAC属于周围型肺癌的一种特殊类型，其影像上与常见的肺炎表现极为相似，如合并感染时，给诊断更带来一定的影响；因此，诊断时应密切结合临床及其它实验室检查结果，对顽固性肺炎应早期采取病理学检查，尽量减少误诊几率。 [关键词] 肺炎型BAC；影像诊断；误诊分析 Analysis of 16 cases of imaging features of pneumonia type bronchioloalveolar carcinoma and the causes of misdiagnosis Ma Hua [Abstract] Objective: To summarize 16 cases of pneumonia type bronchioloalveolar carcinoma ( BAC ) imaging characteristics and analyze the cause of misdiagnosis of the disease, to continuously improve the cognition and diagnosis ability. Methods: clinical data of 16 cases of pneumonia and patients with BAC were retrospectively analyzed the imaging misdiagnosis. Results: 16 cases of pneumonia in patients with type BAC, 9 cases were misdiagnosed as pneumonia, 5 cases of Legionella infection may be considered; 2 cases of pulmonary tuberculosis, chronic bronchitis and inflammation in 2 cases, metastatic tumor in 1 cases, 2 cases of peripheral solitary small pieces of pneumonia. Conclusion: a special type of pneumonia type BAC belongs to the peripheral lung cancer, its imaging performance and common pneumonia is very similar, such as infection, diagnosis more to bring a certain impact; therefore, diagnosis should be combined with clinical and other laboratory results, take early pathological examination of refractory pneumonia as far as possible, reduce misdiagnosis rate. [ keyword ] pneumonia type BAC; imaging diagnosis; Misdiagnosis Analysis 细支气管肺泡细胞癌（BAC，bronchioalveolav carcinoma））是一种特殊类型的原发性支气管肺癌，在WHO分类法中属于腺癌的一个亚型，其发生率约占原发性肿瘤的2%-21%[1,2]。由于其影像学缺乏特征性表现，给影像诊断带来一定的困难，特别是一种肺炎型（或称弥漫型）BAC常常误诊。为不断总结经验，提高BAC的认知和诊断能力，笔者有意对我科2009年2月-2012年3月16例肺炎BAC影像及临床资料进行回顾性分析。现将有关情况汇报如下： 1 资料与方法 1.1 一般资料 本组16例BAC患者，男性7例，女性9例，年龄在38-67岁之间，平均年龄为45.35岁。主要临床表现：10例患者以咳嗽、咯痰就诊，其中有2例伴有咯少量血丝。不规则发热3例，胸痛、呼吸不畅、胸闷