【摘要】 目的　通过对胸部结节病误诊病例的回顾性分析 ,探讨结节病影像诊断存在的问题。方法　复习 32例误诊病例的影像 ,包括胸片和胸部CT及临床资料。病理证实 9例 ,临床治疗证实2 3例。结果　 32例均有胸部淋巴结增大 ,其中 2 3例纵隔淋巴结及两侧肺门淋巴结增大 ,5例纵隔淋巴结及单侧肺门淋巴结增大 ,4例纵隔淋巴结增大而无肺门淋巴结增大。肺部病变有 2 4例 ,其中19例为肺内多发结节 ,肺部斑片状影 4例 ,肺内纤维化 1例。胸膜病变 3例 ,均伴肺内多发结节 ,其中 2例胸腔积液 ,1例胸膜多发小结节。结论　胸部结节病影像不典型时诊断困难 ,需结合临床或治疗中动态观察确诊更多还原

【Abstract】 Objective To discuss the noticeable problems in the radiological diagnosis of thoracic sarcoidosis through retrospective analysis of misdiagnosis. Methods Imaging examinations of 32 misdiagnosed cases with thoracic sarcoidosis including chest radiography, CT, and their clinical data were reviewed. The final diagnosis was made by pathology (9 cases) and clinical therapy (23 cases). Results Enlarged thoracic lymph nodes were detected in all cases. 23 of them presented mediastinal lymph node enlargement associated with bilateral hilar lymph node enlargement, 5 of them had mediastinal lymph node enlargement and unilateral hilar lymph node enlargement, and 4 of them had mediastinal lymph node enlargement without hilar lymph node enlargement. In these cases, 24 had pulmonary abnormalities. 19 of them showed multiple pulmonary nodes, 4 of them had patchy pulmonary shadows, and another 1 had pulmonary fibrosis. Pleural lesions included 2 hydrothorax and 1 multiple pleural nodes, and all of pleural lesions were associated with multiple pulmonary nodes. Conclusion When the radiological findings of thoracic sarcoidosis are atypical, the diagnosis is difficult and must combine with the clinical findings, or the outcome of the treatment.更多还原