结节病ct典型和不典型型表现.ppt

Alveolar sarcoid多房型肉瘤 pattern of airspace consolidation in pulmonary sarcoidosis. Axial high-resolution CT scan shows alveolar consolidation in the left upper lobe and patchy subpleural alveolar opacities in the right upper lobe. Architectural distortion and traction bronchiectasis, signs of fibrosis, also are visible, mainly in the right upper lobe. Axial unenhanced high-resolution CT scan shows asymmetric subpleural honeycomb-like cysts不对称胸膜下蜂窝样囊肿 (ar- rowheads) and architectural distortion associated with left fissure nodularity (arrow). Although these features also are characteristic of idiopathic pulmonary fibrosis特发性肺纤维化, the upper-lobe predominance of honeycomb-like cysts and the peribronchovascular and fissural distribution of micronodules in this case were more suggestive of sarcoidosis.以上叶为主的蜂窝状囊 ，沿支气管血管束周围分布并且更提示结节病。 Miliary opacities in sarcoidosis. 粟粒样结节病 Axial un- enhanced high-resolution CT scan shows countless tiny micronodules representing multiple and diffuse granulomas in a random distribution, with bronchial wall thickening. When this pattern is seen, the differential diagnosis should include miliary tuberculosis, pneumo- coniosis, and metastatic lesions. 无数的小结节表现为随机分布的多发弥漫性肉芽肿，支气管壁增厚。鉴别诊断应包括粟粒性肺结核，尘肺，和转移性病变。 A, High-resolution CT scan of lungs reveals ill-defined small nodular opacities in peribronchovascular and issural distribution. Small amount of interlobular septal thickening少量的小叶间隔增厚 (arrow) is seen. B, Photomicrograph of histopathologic specimen shows noncaseating ？tightly formed granulomas and epithelioid histiocytes and lymphocytes. Perilymphatic distribution of granulomas is evident. Normal lung parenchyma and small region of fibrotic interlobular septal thickening (arrow) are seen. 组织病理标本的显微照片显示紧密的肉芽肿和上皮样细胞和淋巴细胞。肉芽肿淋巴分布是显而易见的。正常肺组织纤维化和小叶间隔增厚（箭头）。 Tracheobronchial and pulmonary involvement of sarcoidosis 主支气管及肺实质受侵 (a) Axial contrast-enhanced CT scan obtained at the subcarinal level shows a soft-tissue mass with punctate calcif