标题：组织胞浆菌性肺结节影像与临床病理特征

      作者：朱文标 1，朱志强 2，卢善明 1    (梅州市人民医院病理科 1、影像中心 2，广东 梅州 514031)

      卷次： 2018年29卷17期

      【摘要】 目的 探讨组织胞浆菌性肺结节的影像特点、病理特征，提高对该病的诊断水平。方法 回顾性分析2016年5月至2018年2月在梅州市人民医院确诊的6例组织胞浆菌性肺结节患者的临床资料、诊断过程、影像特点及病理特征。结果 组织胞浆菌性肺结节可单发或者多发，多发者靠近胸膜结节增多。结节周围不完整的磨玻璃密度晕圈常见，结节中央点灶状钙化多见，部分伴有空洞，增强扫描为边缘不均匀的轻度环形强化。正电子发射计算机断层显像(PET)/CT显示结节代谢轻度增高。患者行CT引导下结节穿刺活检或胸腔镜下结节活检确诊。病理均表现为肉芽肿性炎，病灶内组织细胞胞浆内可查见酵母样组织胞浆菌孢子，PAS染色阳性。结论 组织胞浆菌性肺结节影像学虽缺乏特异性，但结节的分布、钙化及强化仍有一些特点，结节周围常见不完整的磨玻璃密度样晕圈。组织病理检查查见真菌孢子是确诊的主要方法。
      【关键词】 组织胞浆菌性肺结节；影像学特征；临床病理特征
      【中图分类号】 R445 【文献标识码】 A 【文章编号】 1003—6350（2018）17—2449—03

Imaging and clinical pathological features of histoplasmosis pulmonary nodules.
ZHU Wen-biao 1, ZHU Zhi-qiang 2,LU Shan-ming 1. Department of Pathology 1, Imaging Center 2, Meizhou People's Hospital, Meizhou 514031, Guangdong,CHINA
【Abstract】 Objective To investigate the imaging and clinical pathological features of histoplasmosis pulmo-nary nodules and to improve the diagnostic level for the disease. Methods A retrospective analysis was conducted us-ing clinical data, diagnostic process, imaging features and pathological features collected from six patients with histoplas-mosis pulmonary nodules diagnosed in Meizhou People's Hospital from May 2016 to February 2018. Results Histo-plasmosis pulmonary nodules can be single or multiple, with multiple increasing near pleural nodules. Incompleteground glass halo surrounding a nodule was common. Speckle-like focal calcification was more common at the centralof the nodule, and some are accompanied by a cavity. When enhancing the scan, the nodules appear as mild ring enhance-ment with uneven edges. A positron emission tomography-computed tomography (PET)/CT scan showed a slight in-crease in nodule metabolism. All patients were diagnosed by CT-guided biopsy of nodule or thoracoscopic biopsy. Thepathology was characterized by granulomatous inflammation. The yeast-like histoplasma spores could be found in the cy-toplasm of the tissue cells in the lesion, which were positive with PAS staining. Conclusion Although there is no speci-ficity in the imaging of histoplasmosis pulmonary nodules, there are still some characteristics of the distribution, calcifi-cation and enhancement of nodules. Incomplete ground glass hazy density halo around the nodule is common. Histopath-ological examination of fungal spores is the main method of diagnosis.
      【Key words】 Histoplasmosis pulmonary nodules; Imaging features; Clinical pathological features·论 著·doi:10.3969/j.issn.1003-6350.2018.17.024