节点文献
肺淋巴管癌病
Pulmonary lymphangitic carcinomatosis
【摘要】 目的探讨肺淋巴管癌病(PLC)的临床特征,分析相关诊断方法的特点,提高对PLC的认识及其诊断水平。方法结合文献资料回顾分析4例临床病例。结果PLC在临床上主要表现为咳嗽、气短;肺功能呈正常或限制性通气功能障碍;X线胸片常见双肺弥漫性网状、网状结节状或结节状等间质纤维样改变,并合并胸腔积液、高分辨CT可发现小叶间隔的不均匀增厚,不均一的支气管血管束结节状增厚,胸膜不规则增厚,纵隔淋巴结肿大等;胸膜肺组织病理可见胸膜下、肺内淋巴管内癌细胞生长。结论对双肺呈类间质纤维化改变,同时合并胸腔积液和纵隔淋巴结肿大的患者,应进一步行高分辨CT及胸膜肺组织病理活检,以期排除PLC之诊断。
【Abstract】 Objective To explore the clinical manifestations of pulmonary lymphangitic carcinomatosis (PLC), to analyse its associated diagnostic methods, and to improve the understanding of PLC and its diagnosis. Method Retrospective analysis of 4 cases of PLC and review of the literature. Result The clinical manifestations of PLC include: (1) dyspnea and cough; (2) normal or restrictive pattern ventilation; (3) diffuse or local reticulonodular infiltrates in the lung like interstitial fibrosis and pleural effusion on chest radiograph; (4) CT and high resolution CT (HRCT) scans reveal a beaded chain appearance caused by uneven thickening of the interlobular septa and pleural membrane, polygonal thickening of bronchovascular bundles, and mediastinal lymphadenopathy as well. Conclusion These clinical data suggest that any manifestations similiar to pulmonary interstitial fibrosis complicated with pleural effusion and paratracheal lymphadenopathy should be further differentiated from PLC by HRCT and pleural lung tissue biopsy.
【Key words】 Pulmonary lymphangitic carcinomatosis Lung neoplasm Pulmonary interstitial fibrosis;
- 【文献出处】 中华结核和呼吸杂志 ,CHINESE JOURNAL OF TUBERCULOSIS AND RESPIRATORY DISEASES , 编辑部邮箱 ,1998年12期
- 【分类号】R734.2
- 【被引频次】34
- 【下载频次】156