本文报告4例局限性肺部坏死性肉芽肿病,临床颇似肺癌。其中3例有肺部临床症状,1例胸透偶而发现。4例均因怀疑肺癌而分别作了全肺切除(2例)、肺叶切除和肺段切除。痰细胞学检查均阴性,仅一例曾报告不典型细胞,剖胸可见肺内有实质性包块或大小不等的结节,主要病理表现是肉芽肿、血管炎和坏死性病变,但未见形成空洞。显微镜下具三个主要特征:①内芽肿和坏死区之间有不规则的纤维组织,伴有淋巴细胞、浆细胞广泛浸润;②可见大量多核巨细胞、多数为结核巨细胞;③血管炎为最显著特征,小动脉内膜可被淋巴细胞为主之浸润区域所割裂,大动脉壁完全被巨细胞肉芽肿性血管炎破坏,管腔完全闭塞,但病损范围仍很局限,受损血管间仍可见到正常肺组织。4例病变皆呈局限性,除引流淋巴 This article reports 4 cases of localized pulmonary necrotizing granulomatosis, clinical resembling lung cancer. Three cases had clinical symptoms of the lungs, and one case of thorax was found occasionally. Four patients were all diagnosed with lung cancer and were made of pneumonectomy (2 cases), lobectomy and segmentectomy. Sputum cytology were negative, only one case of atypical cells had been reported, the thoracotomy can be seen in the lungs with substantial mass or nodules of different sizes, the main pathological findings are granulomas, vasculitis and necrotizing lesions, but no Forming a hollow. Microscope with three main features: ① between the internal bud and necrosis of the irregular fibrous tissue, accompanied by extensive infiltration of lymphocytes, plasma cells; ② visible a large number of multinucleated giant cells, mostly tuberculous giant cells; ③ vasculitis The most notable feature is that the intima of the arteriole can be severed by the infiltrating area where lymphocytes predominate. The aortic wall is completely destroyed by giant cell granulomatous vasculitis and the lumen is completely occluded, but the extent of the lesion is still limited, with impaired vascular Between the normal lung tissue can still be seen. 4 cases showed limited pathological changes, in addition to drainage of lymph