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目的探讨肺内结块的病理基础及在良、恶性鉴别诊断中的价值。方法搜集经手术切除经病理证实的肺内结块,肺癌(24例)、结核瘤(3例)、炎性假瘤(6例)、具有毛刺CT征结块33例,均采用螺旋CT扫描并结合组织学病理所见,观察和评价毛刺CT征。结果 33例毛刺征按其长度通常一般可分为两类:①短毛刺征(25例),其中(22例)为恶性,3例为良性病变。②长毛刺征8例,其中6例为良性病变,2例为恶性。结论毛刺征是诊断肺恶性肿瘤的征象之一,尤以短毛刺征诊断价值最为重要,该征出现若结合结块的其他特征和临床表现,则可提高对肺恶性肿瘤的诊断的准确率。
Objective To investigate the pathological basis of pulmonary clumps and its value in the differential diagnosis of benign and malignant diseases. Methods Thirty-six patients with pathologically confirmed pulmonary tuberculosis, lung cancer (n = 24), tuberculoma (n = 3) and inflammatory pseudotumor (n = 6) were enrolled in this study. Combined with histological findings, observe and evaluate burr CT signs. Results According to its length, 33 cases of burr were generally divided into two categories: ① short burr sign (25 cases), of which 22 cases were malignant and 3 cases were benign. ② hair spiculation in 8 cases, of which 6 cases of benign lesions, 2 cases were malignant. Conclusion Burr sign is one of the signs of diagnosis of malignant lung cancer. Especially the diagnostic value of short burr is the most important. The combination of other features and clinical manifestations of clumping may improve the diagnostic accuracy of lung malignancy.