先天性肺囊性腺瘤样畸形的影像特征及误诊分析OACSTPCD

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.