细支气管肺泡细胞癌32例临床分析

Clinical analysis of bronchioloalveolar carcinoma in 32 cases

摘要:

目的：分析、总结细支气管肺泡细胞癌（bronchioloalveolar carcinoma，BAC）的临床特点、影像学特点、诊断及鉴别诊断要点，以提高临床医师对BAC的认识和诊治水平。方法：回顾性分析我院呼吸科和胸外科2010年5月至2013年9月诊治的32例BAC患者的临床资料，包括临床表现、胸部影像学检查、实验室检查、病理学检查等资料，并进行分析、总结。结果：BAC临床特点为咳嗽、咳痰、痰中带血、进行性加重的呼吸困难，咳大量白色泡沫痰是BAC的显著特点，但并不是BAC的常见表现。胸部影像学表现分为孤立结节或肿块型、突变型（肺炎型）、弥漫型３种类型，各型均有其典型影像学表现。32例患者均经病理学或细胞学检查确诊为BAC。结论：熟练掌握BAC的临床特点、影像学特征、诊断及鉴别诊断要点，早期行肺活检病理学检查，有助于BAC的早期诊断，可明显减少其误诊、误治率。

Abstract:

Objective：To study and to summarize the clinical feature，imaging feature，key points for diagnosis and differential diagnosis of bronchioloalveolar carcinoma（BAC） so as to improve the clinicians’ understanding，diagnosis and treatment of BAC. Methods：Clinical data of 32 patients with BAC in the department of respiratory and department of thoracic surgery in our hospital from May 2010 to September 2013 were studied retrospectively，including clinical manifestation，thoracic image，laboratory test and pathological examination，etc. Results：Clinical features of BAC were cough，expectoration，blood in sputum，progressive dyspnea；a lot of white frothy sputum was the remarkable characteristic of BAC，but not the common performance. The imaging of BAC was of 3 types：solitary nodular type，pneumonia type and diffusing type，each type had its typical imaging findings. Thirty-two patients were diagnosed as BAC by pathological or cytological examination. Conclusions：Mastering the clinical feature，imaging feature，key points for diagnosis and differential diagnosis of BAC and performing early lung biopsy are contribute to diagnosing BAC at early stage and reducing the rate of misdiagnosis and mistreatment significantly.