肺隐球菌病(PC)肺部CT增强扫描影像表现及临床病理分析

目的观察肺隐球菌病(PC)肺部CT增强扫描影像学表现及病理特点。方法回顾性分析自2009年1月-2015年1月于我院经手术病理证实为肺隐球菌病的54例患者的临床资料,所有患者均接受肺部CT增强扫描,记录其影像学表现,并与病理结果作对照分析。结果本组肺部CT检出多发结节型30例,单发结节型18例,实变型6例,以病变区域位于胸膜下端,与胸膜宽基底相贴,呈炎性肉芽肿改变,呈坏死,无钙化为CT特征,病理可见肉芽肿样病变,PAS(+)、CMS(+)。结论 PC其特异性CT征象为病变区域位于胸膜下端,与胸膜宽基底相贴,病变呈炎性肉芽肿改变,呈坏死表现,无钙化,对非典型病变者,配合病理穿刺活检可提升其诊断准确率。

Imaging Findings and Clinical Pathological Analysis of Pulmonary CT Enhancement Scan of Pulmonary Cryptococcosis (PC)

Objective To investigate the imaging findings and pathological features of pulmonary CT enhancement scan of pulmonary cryptococcosis (PC).Methods The clinical data of 54 patients who had PC confirmed by surgery and pathology and were admitted into the hospital during January 2009 to January 2015 were retrospectively analyzed. All patients underwent CT enhancement scan. The imaging findings were recorded and compared with pathological results.Results There were 30 cases of multiondule type, 18 cases of solitary nodule type and 6 cases of consolidation type detected by pulmonary CT. The lesion areas were located at the lower end of the pleura and were close to the wide base of pleura. The CT findings showed changes of inflammatory granuloma, thanatosis and non-calcification. Pathology indicated granuloma-like lesions, PAS(+) and CMS(+). Conclusion The specific CT findings of PC are lesion areas located in the lower end of the pleura and close to the wide base of pleura. The lesions manifest as changes of inflammatory granuloma, thanatosis and non-calcification. For patients with atypia lesions, the diagnostic accuracy can be improved, combined with pathological biopsy.