摘要
目的 探讨肺隐球菌病的临床特点、影像学表现、病理特征、治疗方法及预后。方法收集南京军区福州总医院2003年3月至2010年2月经病理确诊的38例肺隐球菌病患者的临床资料，并对相关资料进行分析。结果 38例均为社区获得性肺炎，其中男29例，女9例，年龄21～70岁，平均（47±13）岁。38例中伴基础疾病者9例。流式细胞分析CD4细胞正常20例。影像学表现：35例病变靠近胸膜，以下肺部受累多见，其中左下肺21例，右下肺23例；单发结节影11例，多发结节影16例，多发斑片状影3例，肿块伴多发结节5例，弥漫性肺实质浸润影3例；4例患者行18F-脱氧葡萄糖正电子发射计算机断层显像（PET-CT）检查，病灶均有较高的标准化摄取值（SUV值）。经皮肺穿刺活检确诊33例，开胸手术确诊1例，胸腔镜手术确诊3例，淋巴结活检确诊1例。治愈34例，显效3例，死亡1例。结论 在门诊就诊的肺部阴影患者中，肺隐球菌病应作为诊断及鉴别诊断的疾病之一。肺隐球菌病的影像学表现具有病灶多发、靠近胸膜及多位于下肺部等特点，但临床表现无特异性。经皮肺穿刺活检是确诊的有效方法之一。
Objective To investigate the clinical features, radiology, diagnosis and treatment of pulmonary cryptococcosis.MethodsA total of 38 cases of pulmonary cryptococcosis, confirmed by pathological examinations at Fuzhou General Clinical Medical College, Fujian Medical University from March 2003 to February 2010, were retrospectively studied.Results All of the cases were community-acquired.The patients consisted of 29 males and 9 females, aged from 21 to 70 years.There were no underlying diseases in 29 cases.The CD4 cell numbers were normal in 20 patients.Radiological study showed that the majority of the lesions （35 cases） were close to the pleura.Lower lungs were often involved （left 21 and right 23）.Pulmonary nodules, either solitary nodules （11 cases） or multiple nodules （16 cases）, were the most common CT finding.The lesions had a higher standardized uptake value （SUV） in 4 patients with a PET-CT scan.The lung specimens of 33 cases were obtained by CT guided transthoracic needle aspiration biopsy.The disease was cured in 34 cases , and improved in 3 cases, but 1 died.Conclusions Pulmonary cryptococcosis must be considered in the differential diagnosis of lesions of the lungs.The disease has some characteristics on radiology, such as multiple lesions, always close to the pleura and occurs frequently in the lower lungs.CT guided percutaneous biopsy is a safe and effective method for diagnosis.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2011年第9期653-656,共4页
Chinese Journal of Tuberculosis and Respiratory Diseases
关键词
隐球菌病
病理
临床
影像学
Cryptococcosis
Pathology,clinical
Imageology
