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目的探讨原发性肺淋巴瘤的CT表现特点。方法回顾性分析12例肺淋巴瘤患者的临床资料和螺旋CT表现特点。结果其中10例患者出现肺实变,其中上叶2例,中叶7例,下叶1例。8例患者表现为肿块或结节,其中3例患者为单发病灶,5例为多发。4例患者出现肺部磨玻璃样改变,7例患者出现支气管充气征,部分患者合并肺实变。2例患者合并胸腔积液,4例患者表现出胸膜增厚后粘连,2例患者合并纵隔淋巴结肿大。病理结果显示2例患者为霍奇金淋巴瘤,10例患者为非霍奇金淋巴瘤。有6例患者在病理证实之前分别误诊为肺部结核3例,肺部感染2例和肺结节病1例,误诊率高达50%。结论原发性肺淋巴瘤CT表现无特异性,单纯依靠CT误诊率较高,需要结合病史、临床表现和影像学检查综合分析,病理结果可以明确诊断。
Objective To investigate the CT features of primary pulmonary lymphoma. Methods Retrospective analysis of 12 cases of pulmonary lymphoma in patients with clinical data and spiral CT features. Results Of the 10 patients, pulmonary consolidation occurred, including 2 cases of upper lobe, 7 middle lobe and 1 lower lobe. 8 patients showed lumps or nodules, of which 3 patients with single lesions, 5 cases of multiple. Four patients had glass-like changes in the lungs, 7 patients had bronchial airways, and some patients had lung consolidation. Two patients had pleural effusion. Four patients showed pleural thickening and adhesions, and two patients had enlarged mediastinal lymph nodes. Pathological findings showed that 2 patients were Hodgkin’s lymphoma and 10 patients were non-Hodgkin’s lymphoma. Six patients were misdiagnosed as pulmonary tuberculosis (3 cases), pulmonary infection (2 cases) and lung sarcoidosis (1 case) before misdiagnosis. The misdiagnosis rate was as high as 50%. Conclusion The CT findings of primary pulmonary lymphoma are nonspecific. Relying solely on the high misdiagnosis rate of CT, it is necessary to combine the history, clinical manifestations and imaging findings to make a definite diagnosis.