摘要: |
目的:探讨获得性免疫缺陷综合征(AIDS)合并孤立性肿块型肺隐球菌病或周围型肺癌的CT诊断与鉴别诊断。方法:回顾性分析经病理确诊的21例AIDS合并孤立性肿块型肺隐球菌病和14例AIDS合并周围型肺癌患者的胸部CT影像,比较两组患者病灶的分布、大小、内部结构、形态、边缘等。结果:21例孤立性肿块型肺隐球菌病病灶的最大径为(2.03±0.99) cm,显示空洞6例(其中薄壁空洞5例),不规则形6例,分叶征7例、毛刺征4例。14例AIDS合并周围型肺癌患者病灶的最大径为(3.37±2.12) cm,显示磨玻璃影4例,类圆形14例,分叶征12例、毛刺征8例。两组病灶大小、磨玻璃影、空洞、不规则形、分叶征及毛刺征比例差异均有统计学意义(P<0.05)。结论:与合并周围型肺癌相比,孤立性肿块型肺隐球菌病病灶多较小, 分叶征、毛刺征少见,实性不规则形结节和薄壁空洞较多见;CT检查有助于二者的鉴别诊断。 |
关键词: 肺隐球菌 周围型肺癌 X线计算机断层扫描 获得性免疫缺陷综合征 鉴别诊断 |
DOI:10.12025/j.issn.1008-6358.2019.20190030 |
分类号:R 81 |
基金项目:上海市科委医学引导类(西医)科技支撑项目(19411965800). |
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Computed tomography differential diagnosis of pulmonary cryptococcosis of solitary mass type and peripheral lung cancer in patients with acquired immune deficiency syndrome |
王峻峰,周 粟,施裕新,史维雅,宋凤祥,詹 艺,单 飞
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Abstract: |
Objective:To investigate the CT differential diagnosis of pulmonary cryptococcosis of solitary mass type and peripheral lung cancer in patients with acquired immune deficiency syndrome (AIDS). Methods:The chest CT imaging results of 21 AIDS patients combined with pulmonary cryptococcosis of solitary mass type and 14 AIDS patients combined with peripheral lung cancer proved by pathology were analyzed retrospectively. The differences of CT imaging results in location, size, internal structure, morphology, and margin were explored statistically. Results:The maximum diameter of the lesions of 21 cases with pulmonary cryptococcosis of solitary mass type was (2.03±0.99) cm, 6 cases showed cavities (5 cases showed thinwalled cavities), 6 cases showed irregular shapes, 7 cases showed lobulation sign, and 4 cases showed spiculation sign. The size of the lesion of 14 cases with peripheral lung cancer was (3.37±2.12) cm, 4 cases showed ground glass opacity, 14 cases showed circular, 12 cases showed lobulation sign, and 8 cases showed spiculation sign. There were statistically significant differences between the two groups in lesion size, ground glass opacity, cavity, irregular shape, lobulation sign, and spiculation sign (P<0.05). Conclusions:Compared with peripheral lung cancer, the lesions of pulmonary cryptococcosis of solitary mass type rarely had lobulation sign and spiculation sign, while mostly had small volumes, solid irregular nodules, and thin wall cavity. CT examination may be helpful for the differential diagnosis between pulmonary cryptococcosis of solitary mass type and peripheral lung cancer. |
Key words: pulmonary cryptococcosis peripheral lung cancer Xray computed tomography acquired immune deficiency syndrome differential diagnosis |