肺淋巴瘤样肉芽肿的CT影像表现
CT Findings of Pulmonary Lymphomatoid Granulomatosis
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摘要: 目的:探讨肺淋巴瘤样肉芽肿(LYG)的CT影像表现。方法:回顾性分析8例肺部LYG病例的CT影像表现,男性3例,女性5例,平均年龄42岁,其中5例含增强扫描。结果:病理结果2例为1级,4例为2级,2例为3级;6例多发,其中1例为多发结节,4例以多发结节或肿块为主,伴有不同程度斑片影,1例为斑片影为主伴多发小结节;2例表现为单发结节或肿块;3例下肺分布为主,3例上肺分布为主,2例上下肺都有分布,6例多发结节均沿着支气管血管束分布,其中5例有胸膜下病灶分布。8例病灶结节或肿块边缘粗糙,周围均有晕征;4例平扫可见病灶中央较外周密度稍低;3例可见到空气支气管征;1例病灶内见小空洞;5例行增强扫描病例均可见病灶边缘强化,中心平均强化值13.2Hu。5例伴纵隔淋巴结肿大。结论:沿支气管血管束分布的多发结节或肿块,伴周围晕征以及边缘环形强化为肺部LYG的常见表现。Abstract: Objective: To investigate characteristic CT findings of pulmonary lymphomatoid granulomatosis and to improve the knowledge of this disease. Methods: CT imaging data of 8 pathologically confirmed pulmonary lymphomatoid granulomatosis cases were retrospectively reviewed, including 3 men and 5 women, the average age was 42 years. Five of the cases underwent contrast enhanced scan. Results: Histologically, two patients were grade l, four were grade 2 and two were grade 3. Six patients showed multiple lesions on CT images, one of which showed multiple nodules, four cases showed mainly multiple nodules or masses with varying amounts of patchy lesions, and one patient was mainly patchy lesion with a few small nodules. Two patients showed solitary nodule or mass on CT images; Three patients showed lower hmg preponderance, three patients were upper lung preponderance, the other two patients showed lesions in both upper and lower lung. In the six patients with multiple lesions, the lesions distributed along the peribronchovascular huddle, five of which showed subpleural lesions. Nodules and masses in all patients showed coarse margin, with halo sign. Four patients showed low attenuation center. Air bronchograms were seen in three cases. Cavitation was seen in one case. All the five cases with contrast enhanced scan showed ring-like peripheral enhancement. Lymphadenopathy were seen in 5 patients, the average enhancement of center was 13.2Hu. Conclusions: Multiple nodules or masses with peribronchovascular and subpleural distribution, accompanied by halo sign and ring-like peripheral enhancement are common CT manifestations of LYG.