临床误诊误治2024，Vol.37Issue(8)：10-14,19,6.DOI:10.3969/j.issn.1002-3429.2024.08.003
先天性肺囊性腺瘤样畸形的影像特征及误诊分析
Radiological Characteristics and Misdiagnosis of Congenital Cystic Adeno-matoid Malformation of the Lung
摘要
Abstract
Objective To investigate the imaging features of congenital cystic adenomatoid malformation(CCAM)of lung,to analyze the causes of misdiagnosis,and to summarize the preventive measures.Methods The clinical data of 9 pa-tients with CCAM confirmed by surgery and pathological examination from May 2020 to November 2023 were retrospectively analyzed.Results The main manifestations of 5 patients in this group were intermittent cough,sputum,blood in sputum,fe-ver and shortness of breath,etc.Three patients were found abnormal lung by routine physical examination during hospitaliza-tion,and 1 patient was found abnormal lung by routine physical examination.Two patients were diagnosed and 7 patients were misdiagnosed,including 3 patients misdiagnosed with bronchogenic lung cyst,1 patient with pulmonary abscess,1 patient with cystic bronchiectasis with infection,1 patient with pulmonary isolation sign and 1 patient with congenital lobar emphyse-ma.Misdiagnosis lasted 8 d to 2 weeks.CT examination showed that 4 of the 9 patients had large cystic type.CT showed a large cystic cavity containing gas or liquid occupying the chest cavity,and there were curved thin line compartments or gas-liquid planes in the cystic cavity.In 5 patients with small cystic type,the CT findings showed multiple thin-walled sacs con-fined to one lobe of the lung,some of which were honeycomb-like,and some showed short gas-liquid plane.All 9 patients un-derwent single-port video-assisted thoracoscopic lobectomy or segmental resection,and the pathological examination showed Stocker type Ⅰ in 4 patients of large cystic type and Stocker type Ⅱ in 5 patients of small cystic type.All the 9 patients were followed up for 0.5-1.0 year after discharge,and the prognosis was good.Conclusion CCAM has different imaging features due to different pathological types.Although it is more likely to be misdiagnosed,it still has certain special imaging character-istics,and pathological examination is needed to confirm the diagnosis.关键词
囊性腺瘤样畸形/肺/先天性/体层摄影术,螺旋计算机/病理检查/误诊/囊肿/肺脓肿Key words
Cystic adenomatoid malformation/Lung/Congenital/Tomography,spiral computed/Pathology examina-tion/Misdiagnosis/Cysts/Lung abscess分类
临床医学引用本文复制引用
焦振华,刘连锋,郭文文,秦琛琛,李天云..先天性肺囊性腺瘤样畸形的影像特征及误诊分析[J].临床误诊误治,2024,37(8):10-14,19,6.基金项目
陕西省自然科学基础研究计划项目(S2024-JC-QN-0640) （S2024-JC-QN-0640）
