肺炎性假瘤CT表现及误诊分析

Inflammatory pseudotumor of the lung：CT findings and misdiagnosis analysis

摘要:

目的：分析肺炎性假瘤（Inflammatory pseudotumor of the lung，IPL）的CT表现，提高对本病的认识。方法：回顾性分析26例经病理证实的IPL的CT表现及误诊原因。结果：病变部位：病灶位于右肺20例、左肺6例；形态：19例病灶为扇形团块影，7例为类球状影；边缘：17例边缘呈刀切样改变，5例边缘密度低的晕圈状改变；密度：平扫均匀者14例，不均匀者12例，CT值12~41 HU之间，增强扫描4例明显均匀强化，强化后CT值超过100 HU，9例边缘明显强化伴中央液化、坏死，6例中度强化，强化后CT值在70~80 HU之间。胸膜：14例胸膜增厚、局部形成幕状、线状粘连带。淋巴结：7例淋巴结增大。结论：IPL CT特点：单发病灶、位于胸膜下，多呈扇形团块、增强明显强化，边缘呈刀切样改变。全面分析病史及CT表现，对减少误诊很有帮助。

Abstract:

Objective：To study the CT features of inflammatory pseudotumor of the lung（IPL） and to improve the understanding of IPL. Methods：CT findings were retrospectively reviewed in 26 patients with IPL proved by pathology. Results：The lesions of 20 pa－tients were located at the right lung and those of 6 patients were at the left lung. The lesions usually presented different appearances：19 cases of irregular fan-shape，7 cases of spherical shape，a knife cut edge in 17 cases and 5 cases of low density halo-shape. The density of the lesions was homogeneous in 14 cases and heterogeneous in 12 cases，with CT value of 12-41 HU；4 cases were highly enhanced，with CT value reaching more than 100 HU；9 cases were significantly enhanced on the edge；6 cases were moderately en－hanced and the CT value was 70-80 HU. Pleural change：wide base of 14 cases with adjacent pleural thickening. Seven patients with primary lymph node enlargement. Conclusions：The main CT features of IPL are as follows：the lesions were usually single，adjacent pleural，fan-shaped and highly enhanced；the edge has the burr. The comprehensive analysis of clinical history and CT imaging is helpful to improve the accuracy of diagnosis of this disease，and reduces the rate of misdiagnosis