肺部CT多发磨玻璃结节的病理诊断分析

CT in pathologic diagnosis of multiple lung ground-glass opacity nodules

  • 摘要: 目的 探讨影像上持续存在的多发磨玻璃结节(ground-grass opacity,GGO)在病理组织学上的特点。 方法 回顾分析本院2010年6月-2012年8月肺CT上存在磨玻璃结节且有病理诊断的病例,统计分析多发磨玻璃结节患者在病理诊断、影像特征等方面的特点,及其随访结果。 结果 103例GGO患者中,表现为多发GGO 27例,孤立GGO 76例。多发GGO 51个,包括不典型腺瘤样增生(atypical adenomatous hyperplasia,AAH)14个,细支气管肺泡癌(bronchoalveolar carcinoma,BAC)11个,腺癌18个,间质性肺炎4个,机化性肺炎2,肺结核2个;孤立GGO 76个,包括AAH 9个,BAC 20个,腺癌34个,机化性肺炎5个,间质性肺炎3个,肺出血2个,肺结核2个,错构瘤1个。多发GGO患者中女性(P=0.012 4< 0.05)更多,病灶直径比孤立GGO小(P=0.017 5< 0.05)、磨玻璃成分比例更高(P=0.030 3< 0.05)。胸膜牵拉征在孤立GGO中更常见(P=0.014 9< 0.05),多发GGO边缘光滑更常见(P=0.028 3< 0.05)。除1例多发GGO患者,其他均无术后复发。 结论 肺多发磨玻璃结节的病理、影像特征与孤立磨玻璃结节有所不同。随访发现,这两种结节预后相似。

     

    Abstract: Objective To study the histopathological features of persistent lung multiple ground-glass opacity (GGO) nodules. Methods The pathological diagnosis, CT features and follow-up data of 103 patients with GGO nodules admitted to our hospital from June 2010 to August 2012 were retrospectively analyzed. Results Of the 103 parents, 27 were diagnosed with multiple GGO nodules and 76 with solitary GGO nodules. Of the 51 multiple GGO nodules, 14 were atypical adenomatous hyperplasia (AAH), 11 were bronchioloalveolar carcinoma (BAC), 18 were adenocarcinoma, 4 were interstitial pneumonia, 2 were organizing pneumonia and 2 were phthisis. Of the 76 solitary GGO nodules, 9 were AAH, 20 were BAC, 34 were adenocarcinoma, 5 were organizing pneumonia, 3 were interstitial pneumonia, 2 were pneumorrhagia, 2 were phthisis and 1 was hamartoma. The number of female patients with multiple GGO nodules was greater than that male patients with multiple GGO nodules, the diameter of multiple GGO nodules was longer than that of solitary GGO nodules, the composition of grounded glass was higher in multiple GGO nodules than in solitary GGO nodules, the pleural retraction syndrome was more common in patients with solitary GGO nodules than in those with multiple GGO nodules, the margin of multiple GGO nodules was smoother than that of solitary GGO nodules (P< 0.05). No recurrence occurred in all patients except in 1 (P< 0.05). Conclusion The pathological and CT features of persistent lung multiple GGO nodules are different from those of solitary GGO nodules. However, their prognosis is similar during the follow-up period.

     

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