CAJ | 학술논문

目的总结成人肺隔离症的临床、病理特点.方法收集并分析四川大学华西医院经手术病理活检证实的16例18岁以上成人肺隔离症患者的临床及病理资料.结果 16例肺隔离症患者中女性12例,男性4例,中位年龄38.5岁；咳嗽(9例)是最常见的症状.CT显示病灶位于左肺下叶9例,8例表现为肺囊肿样改变和(或)多发囊状支气管扩张,其次为肺内及其他组织器官软组织密度肿块影(7例)；1例肺部增强CT显示异常的体循环供血动脉.初诊时仅2例诊断为肺隔离症,余误诊为肺囊肿样改变伴支气管扩张6例,肿瘤6例.16例患者均行外科手术治疗,手术证实13例为叶内型肺隔离症,3例为叶外型肺隔离症,组织病理学检查显示肺组织发育不良及慢性炎症性改变.结论肺隔离症以异常动脉供血和肺组织发育不良为特征,临床症状无特异性,初诊误诊率较高,增强CT可作为成人疑似病例(尤其是左肺下叶出现囊状或肿块状病灶的中青年患者)的首选检查方法.
목적 총결성인폐격리증적림상、병리특점.방법 수집병분석사천대학화서의원경수술병리활검증실적16례18세이상성인폐격리증환자적림상급병리자료.결과 16례폐격리증환자중녀성12례,남성4례,중위년령38.5세；해수(9례)시최상견적증상.CT현시병조위우좌폐하협9례,8례표현위폐낭종양개변화(혹)다발낭상지기관확장,기차위폐내급기타조직기관연조직밀도종괴영(7례)；1례폐부증강CT현시이상적체순배공혈동맥.초진시부2례진단위폐격리증,여오진위폐낭종양개변반지기관확장6례,종류6례.16례환자균행외과수술치료,수술증실13례위협내형폐격리증,3례위협외형폐격리증,조직병이학검사현시폐조직발육불량급만성염증성개변.결론 폐격리증이이상동맥공혈화폐조직발육불량위특정,림상증상무특이성,초진오진솔교고,증강CT가작위성인의사병례(우기시좌폐하협출현낭상혹종괴상병조적중청년환자)적수선검사방법.
Objective To explore the clinicopathological features of adult pulmonary sequestration and summarize the misdiagnosis experiences.Methods Data of 16 cases of adult pulmonary sequestration ( 18 years),who were confirmed by surgery and biopsy in our hospital were collected and reviewed.Results The median age of all the patients was 38.5 years.The female seemed to be more likely to suffer from adult pulmonary sequestration ( n =12) with cough to be the most frequent symptom ( n =9 ).CT scans revealed most of the lesions were located in the left lower lobes of the lungs ( n =9 ).Half of the lesions were characterized by pulmonary cyst-like changes and/or multiple cystic bronchiectasis ( n =8 ),followed by soft tissue mass in or out of the lung fields ( n =7).Enhanced CT scans showed abnormal arteries from the systemic circulation.Only two cases were diagnosed as pulmonary sequestration correctly in the primary diagnosis.The remaining were mostly misdiagnosed as pulmonary cyst-like changes with bronchiectasis ( n =6) or tumors (n =6).According to the findings during surgery,13 cases were intralobar pulmonary sequestrations; 3 cases were extralobars,whose tissues were all detected dysplasia and chronic inflammatory by histopathological examinations.Conclusions The misdiagnosis rate of pulmonary sequestration is high because of its non-specific clinical symptoms.Since it is characterized by abnormal arteries and pulmonary dysplasia,enhanced CT scans should be used as a preferred screening method for suspected cases,especially for those middleaged patients with cystic or mass-like lesions in the left lower lobes of the lungs.