CAJ | 학술논문

目的：探讨肺真菌病的病原学分布和影像学特征。方法收集肺真菌病59例，均经支气管镜、经皮肺穿刺活检或手术切除送病理学确诊，分析其病原学分布和影像学特征。结果59例病理学确诊肺真菌病患者中，肺曲霉病24例（40．7％），肺隐球菌病24例（40．7％），肺毛霉病5例（8．5％），肺念珠菌病4例（6．8％），组织胞浆菌病2例（3．4％），合并放线菌肺炎1例（1．7％）。胸部影像学改变包括肺部肿块23例（39．0％），渗出性病变23例（39．0％），结节8例（13．6％），支气管肿物3例（5．1％），空洞病变1例（1．7％），弥漫性病变1例（1．7％）。误诊为肺炎12例（20．3％），肺结核7例（11．9％），肺癌4例（6．8％）。结论病理学确诊的肺真菌病以肺曲霉病和肺隐球菌病为多见，影像学表现主要以肺部肿块影和渗出性病变为主。肺真菌病影像学表现多种多样、缺乏特征性，诊断应尽早取得病理学依据。
목적：탐토폐진균병적병원학분포화영상학특정。방법수집폐진균병59례，균경지기관경、경피폐천자활검혹수술절제송병이학학진，분석기병원학분포화영상학특정。결과59례병이학학진폐진균병환자중，폐곡매병24례（40．7％），폐은구균병24례（40．7％），폐모매병5례（8．5％），폐념주균병4례（6．8％），조직포장균병2례（3．4％），합병방선균폐염1례（1．7％）。흉부영상학개변포괄폐부종괴23례（39．0％），삼출성병변23례（39．0％），결절8례（13．6％），지기관종물3례（5．1％），공동병변1례（1．7％），미만성병변1례（1．7％）。오진위폐염12례（20．3％），폐결핵7례（11．9％），폐암4례（6．8％）。결론병이학학진적폐진균병이폐곡매병화폐은구균병위다견，영상학표현주요이폐부종괴영화삼출성병변위주。폐진균병영상학표현다충다양、결핍특정성，진단응진조취득병이학의거。
Objective To observe the etiological distribution and imaging features of pulmonary fungal dis -ease that was diagnosed by pathology in the People′s Hospital of Guangxi Zhuang Autonomous Region .Methods Fif-ty-night patients with pulmonary fungal disease were collected and analyzed in the People ′s Hospital of Guangxi Zhuang Autonomous Region from June 2004 to March 2013 .The diagnosis of all the patients was confirmed by patho-logical examination ,of lung or bronchi tissue that was obtained by bronchoscope , percutaneous lung puncture biopsy or operation.Results Of the 59 patients who were diagnosed having pulmonary fungal disease by pathology , 24 pa-tients(40.7%) suffered from pulmonary aspergillosis ,24 patients(40.7%) suffered from pulmonary cryptococcosis , 5 patients(8.5%) suffered from pulmonary mucormycosis , 4 patients(6.8%) suffered from pulmonary candidiasis , 2 patients(3.4%) suffered from histoplasmosis , 1 patients(1.7%) suffered from actinomycetes pneumonia .Imaging manifestations of chest included lung mass in 23 cases ( 39.0%) , exudative process in 23 cases ( 39.0%) , lung nodes in 8 cases(13.6%), bronchus neoplasm in 3 cases(5.1%), cavitary lesions in 1 cases(1.7%), diffuse le-sions in 1 cases(1.7%).Of the 59 patients, pulmonary fungal disease was misdiagnosed as pneumonia in 12 cases (20.3%), pulmonary tuberculosis in 7 cases(11.9%), and lung cancer in 4 cases(6.8%).Conclusion The pul-monary aspergillosis and cryptococcosis is common in pulmonary fungal disease diagnosed by pathology ,and the ima-ging manifestations of chest mainly include lung mass and exudative process .Imaging manifestations of chest of pul-monary fungal disease are multifarious and have no characteristics .Thus diagnosis should be confirmed by pathologi-cal evidence as soon as possible .