肺朗格罕斯细胞组织细胞增生症的HRCT表现及随访观察

摘要

Objective To study the HRCT findings and follow-up observation of pulmonary langerhans cell histiocytosis, and to make a further understanding of the disease.Methods Thirteen patients'HRCT and clinical manifestations with pathologically confirmed PLCH were tetrospectively analyzed.Results The main findings in 13 PLCHs were cysts, nodules and pulmonary interstitial changes.One case had nodules which most had cavitation, two cases only had custs, three cases showed nudules and pulmonary interstitial changes, one case had cysts, nodules and pulmonary interstitial changes, the other six cases showed cysts and nodules.Thirteen cases had lesion not only in the upper and middle but in the lower lung field, of which two cases had more lesion in the upper lung and costophrenic angle field and three cases had more lesions in the superior lobe and apical segment of lower lobe.Two case had more lesions in in the lower lung field, and the other six cases had more lesions in the superior lobe and less lesions in the apical segment of lower lobe.Followed-up of 9 patients, 6 cases improved, 1 case progressed, and 2 cases resembled.Conclusion HRCT and clinical manifestation of PLCH are helpful for the early diagnosis.%目的 探讨肺朗格罕斯细胞组织细胞增生症(PLCH)的高分辨CT (HRCT)表现与随访观察,加深对本病的认识.方法 回顾性分析13例经病理证实的PLCH患者的HRCT征象、临床表现和随访观察,分析病变的特征性表现.结果 本组13例PLCH的主要CT表现为结节影、囊腔及肺间质性改变,其中1例仅表现为结节影且大多数结节内可见空洞形成,2例仅表现为囊腔,3例表现为囊腔合并间质性改变,1例表现为结节、囊腔与间质性改变并存,余6例表现为结节与囊腔并存.病变的分布:13例上、中、下肺均见,其中2例以双肺尖及肋膈角区明显,3例以双上肺及下叶背段为著,2例表现为双肺下叶明显,余6例表现为双肺上叶为著,而肋膈角区相对较轻.随访9例患者,6例出现好转,1例进展,2例相仿.结论 PLCH的HRCT及临床表现有一定的特征性,认识这些特征,有助于对本病的诊断.