摘要
目的分析CT表现为双肺弥漫磨玻璃影的肺非霍奇金淋巴瘤(PNHL)的临床特点。方法8例CT表现为双肺弥漫磨玻璃影的肺非霍奇金淋巴瘤患者,采用螺旋CT进行全身扫描。观察分析患者实验室检查情况、影像学及病理学检查情况、误诊情况、治疗情况。结果8例患者血红蛋白均较正常值下降,平均下降(26.0±2.7)g/L;乳酸脱氢酶均增高;4例患者肺功能及弥散功能障碍。4例单纯表现为双肺磨玻璃影,4例患者双肺磨玻璃影伴实变,其中2例伴有小叶结节影,2例伴有纵隔淋巴结肿大。4例患者通过纤维支气管镜检查确诊,2例患者经过CT引导经皮肺穿刺活检确诊,2例患者经胸腔镜肺活检确诊。病理表现:肺泡间隔及肺泡内淋巴细胞浸润2例,肺泡内含铁血黄素沉积3例,肺血管内淋巴细胞浸润2例。8例患者均被误诊,4例误诊为过敏性肺炎,3例误诊为肺部感染,1例误诊为肺泡蛋白沉积症。随访时间3~7个月,平均随访(5.3±0.9)个月,6例B细胞淋巴瘤化疗后病情缓解,2例T细胞淋巴瘤合并肺部感染未进行化疗,分别于5个月和7个月后死亡。结论CT表现为双肺弥漫磨玻璃影的肺非霍奇金淋巴瘤临床表现缺乏特异性,出现并发症之前易被误诊。对于肺非霍奇金淋巴瘤尚无统一的治疗标准,主要包括观察、病灶切除,广泛转移采用化疗和放疗等。
Objective To analyze the clinical features of CT findings of pulmonary non-Hodgkin’s lymphoma(PNHL)with diffuse ground glass in both lungs.Methods A total of 8 cases of pulmonary non-Hodgkin’s lymphoma patients with diffuse ground glass in both lungs were scanned with spiral CT.The laboratory examination,imaging and pathological examination,misdiagnosis and treatment condition were observed and analyzed.Results The hemoglobin of 8 patients was lower than the normal value,with an average decrease of(26.0±2.7)g/L;lactate dehydrogenase was increased;4 patients had pulmonary function and diffusion dysfunction.4 patients showed bilateral ground glass shadow,4 patients had bilateral ground glass shadow with consolidation,including 2 cases of lobular nodular shadow,2 cases of mediastinal lymphadenopathy.4 patients were confirmed by fiberbronchoscopy,2 patients were confirmed by CT guided percutaneous lung biopsy,and 2 patients were confirmed by thoracoscopic lung biopsy.Pathological findings:alveolar septum and lymphocytic infiltration in 2 cases,hemosiderin deposition in 3 cases,and lymphocytic infiltration in 2 cases.All 8 patients were misdiagnosed,4 cases were misdiagnosed as allergic pneumonia,3 cases were misdiagnosed as a pulmonary infection,and 1 case was misdiagnosed as alveolar proteinosis.The follow-up time was 3-7 months,with average follow-up of(5.3±0.9)months.6 cases of B-cell lymphoma were relieved after chemotherapy,2 cases of T-cell lymphoma with pulmonary infection were not treated with chemotherapy,and died 5 and 7 months later,respectively.Conclusion The clinical features of pulmonary non-Hodgkin’s lymphoma with diffuse ground glass shadow of both lungs on CT are lack of specificity,and it is easy to be misdiagnosed before occurrence of complications.There is no unified treatment standard for pulmonary non-Hodgkin’s lymphoma,mainly including observation,focal resection,extensive metastasis,chemotherapy and radiotherapy.
作者
马晖
Ma Hui(Radiology Department,Liaoyang County Central Hospital,Liaoyang 111200,China)
出处
《中国现代药物应用》
2020年第4期21-23,共3页
Chinese Journal of Modern Drug Application
关键词
肺非霍奇金淋巴瘤
双肺弥漫磨玻璃影
临床特点
Pulmonary non-Hodgkin’s lymphoma
Diffuse ground glass shadow in both lungs
Clinical features
