| 王露萍,贺文广,王小丽,李君,楼海燕.肺放线菌病的临床和CT表现特征分析[J].浙江中西医结合杂志,2021,31(2): |
| 肺放线菌病的临床和CT表现特征分析 |
| CT Imaging and Clinical Features of Primary Actinomycosis |
| 投稿时间：2020-06-21 修订日期：2020-08-18 |
| DOI： |
| 中文关键词: 放线菌病 肺 体层摄影术，X线计算机 临床表现 |
| 英文关键词:Actinomycosis Lung Tomography , X -ray computed Clinical features |
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| 中文摘要: |
| 目的：探讨肺放线菌病（Primary Actinomycosis）的临床及CT表现，提高对该病的认识。方法：回顾性分析浙江大学医学院附属第一医院2014年6月至2019年5月期间经病理确诊的16例肺放线菌病患者的临床资料及CT表现。结果：16例患者中，男性13例，女性3例，平均年龄57.9岁；8例吸烟、6例酗酒病史。临床表现：咳嗽15例，咳痰15例、痰中带血或咯血9例、发热4例，胸闷4例及胸背部痛2例。CT表现：病灶均发生于单侧肺，其中右肺12例，左肺4例；胸膜下分布7例。肺实质型放线菌病15例，支气管扩张型肺放线菌病1例。肺实质型放线菌病表现为团片影5例，团块影7例，节段性实变2例，结节1例；病灶内低密度区7例；虫蚀样空洞7例；钙化2例。纵隔及患侧淋巴结肿大5例。结论：肺放线菌病的临床表现缺乏特异性，吸烟酗酒病史+口腔不良卫生习惯、胸膜下实变性肉芽肿、实变中坏死+空洞的CT表现能够帮助诊断肺放线菌病。 |
| 英文摘要: |
| Objective To investigate the clinical and CT imaging features of pulmonary actinomycosis, so as to improve awareness of this disease. Methods The clinical data and CT findings of 16 patients with pulmonary actinomycosis confirmed by pathology from 2014 to 2019 in The First Affiliated Hospital of Zhejiang University were analyzed retrospectively. Results In total 16 patients, 13 males , 3 females, the mean age was 57.9 years old; 8 smokers, 6 alcoholics. Clinical manifestations: 15 cases of cough, 15 cases of sputum, 9 cases of blood or hemoptysis in sputum, 4 cases of fever, 4 cases of chest tightness and 2 cases of chest and back pain. CT features: All lesions occurred in unilateral lungs, including 12 cases of right lung, 4 cases of left lung；7 cases of subpleural distribution. There were 15 cases of parenchymal actinomycosis and 1 case of bronchiectasis form actinomycosis. Parenchymal actinomycosis showed 5 cases of patchy hypodensity with ill-defined margins , 7 cases of mass shadow, 2 cases of segmental consolidation, 1 case of nodules; 7 cases had low-density areas; worm-like cavitation was seen in 7 cases; 2 cases of calcification. Mediastinal and ipsilateral lymphadenopathy in 5 cases. Conclusion The clinical manifestations of pulmonary actinomycosis lack specificity. Combining relevant medical history and CT imaging performance are helpful for the diagnosis. |
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