CT findings of pulmonary cryptococcosis in immunocompetent patients
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摘要: 目的 研究免疫正常患者肺隐球菌病的CT表现。 方法 回顾分析台州恩泽医院2014年9月-2016年9月经病理确诊的32例无基础疾病及免疫缺陷肺隐球菌患者的临床资料和CT表现。 结果 32例肺隐球菌患者中,结节/肿块型24例(75.0%),实变型7例(21.9%),混合型1例(3.1%)。结节/肿块型中单发16例(66.7%),多发8例(33.3%);实变型中单发1例(14.3%),多发6例(85.7%)。15例多发病例中,单肺叶分布占据66.7%(10例)。所有患者共检出69个可评估病灶,其中周围型分布占据66.7%(46个),下肺区分布占50.7%(35个)。48个结节/肿块病灶中空气支气管征发生率为62.5%(30个),其中Ⅲ型为18个(ⅢA型13个,ⅢB型5个),Ⅴ型10个,Ⅳ型2个,未见Ⅰ/Ⅱ型;晕征、分叶、毛刺、空洞及胸膜改变发生率分别为41.6%、29.2%、16.7%、12.5%、25.0%。21个实变病灶中,晕征发生率为85.7%(18个),胸膜增厚发生率为76.2%(16个),空气支气管征发生率为81.0%(17个),其中ⅢA型3个,ⅢB型12个,Ⅴ型2个,未见Ⅰ/Ⅱ/Ⅳ型;空洞发生率38.1%(8个)。 结论 免疫正常患者肺隐球菌病好发于下叶胸膜下,以单发结节/肿块型为主,ⅢA型、V型空气支气管征是其主要特征;而ⅢB型空气支气管征是实变型病灶的特征表现。
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关键词:
- 肺 /
- 隐球菌 /
- 体层摄影术,X线计算机
Abstract: Objective To analyze the CT findings of pulmonary cryptococcosis in immunocompetent patients. Methods CT features and clinical data of 32 immunocompetent patients with histopathologically-proven pulmonary cryptococcosis were retrospectively and analyzed. Results Of the 32 immunocompetent patients, there were mass/nodule pattern(75.0%, n=24), pulmonary consolidation pattern(21.9%, n=7) and the mixed type(3.1%, n=1). In mass/nodule pattern, the occurrence rate of single solitary mass/nodule was 66.7%(n=16), and the multiple mass/nodule was 33.3%(n=8);in pulmonary consolidation pattern, the occurrence rate of single solitary was 14.3%(n=1), and the multiple was 85.7%(n=6). Of all the 15 multiple patients, the occurrence rate of unilateral lobar distribution was 66.7%(n=10). In all sixty-nine measurable lesions, the peripheral distribution(66.7%, n=46) and lower pulmonary distribution (50.7%, n=35) were seen more. In 48 mass/nodule pattern, the occurrence rate of air-bronchogram sign was 62.5%(n=30), include ⅢA(n=13), ⅢB(n=5), Ⅴ(n=10), Ⅳ(n=2), without Ⅰ/Ⅱ;Other findings included halo sign (41.6%), lobulation sign(29.2%), spicule sign(16.7%), cavity or vocule sign(12.5%) and pleural change(25.0%). In 21 pulmonary consolidation pattern, the CT findings included halo sign(85.7%, n=18), pleural incrassation sign(76.2%, n=16), cavity or vocule sign(38.1%, n=8) and air-bronchogram sign(81.0%, n=17), include ⅢA(n=3), ⅢB(n=12 patients), Ⅴ(n=12), without Ⅰ/Ⅱ/Ⅳ. Conclusion The pulmonary cryptococcosis in immunocompetent patients usually occurs in lower lobe near pleural, the mass/nodule pattern is the prevalent CT manifestation, the air-bronchogram sign(type ⅢA, Ⅴ) is the most common CT finding;the air-bronchogram sign(type ⅢB) is the characteristic findings of CT manifestationgs in pulmonary consolidation pattern.-
Key words:
- Lung /
- Cryptococcosis /
- Tomography, X-ray computed
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