高占成 邓晓梅 曹兆龙 回允中 何权瀛 丁东杰 100044 北京医科大学人民医院呼吸科(高占成、邓晓梅、曹兆龙、何权瀛、丁东杰)，病理科(回允中) 中华结核和呼吸感染 1998 12 21 12


    关键词：肺淋巴管癌病；肺肿瘤；肺间质纤维化 期刊 zhjhhhxgr 0 论 著 fur -->


    

【摘要 】 目的 探讨肺淋巴管癌病 (PLC) 的临床特征，分析相关诊断方法的特点，提高对PLC的认识及其诊断水平。方法 结合文献资料回顾分析4例临床病例。结果 PLC在临床上主要表现为咳嗽、气短；肺功能呈正常或限制性通气功能障碍；X线胸片常见双肺弥漫性网状、网状结节状或结节状等间质纤维样改变，并合并胸腔积液、高分辨CT可发现小叶间隔的不均匀增厚，不均一的支气管血管束结节状增厚，胸膜不规则增厚，纵隔淋巴结肿大等；胸膜肺组织病理可见胸膜下、肺内淋巴管内癌细胞生长。结论 对双肺呈类间质纤维化改变，同时合并胸腔积液和纵隔淋巴结肿大的患者，应进一步行高分辨CT及胸膜肺组织病理活检，以期排除PLC之诊断。

Pulmonarylymphangitic carcinomatosis

Gao Zhancheng, DengXiaomei, Cao Zhaolong, et al. Departments of Respiratory Medicine and Pathology, People ′ s Hospital, Beijing MedicalUniversity, Beijing 100044

【 Abstract 】 Objective To explore the clinicalmanifestations of pulmonary lymphangitic carcinomatosis (PLC), to analyse its associateddiagnostic methods, and to improve the understanding of PLC and its diagnosis. Method Retrospective analysis of 4 casesof PLC and review of the literature. Result The clinical manifestations of PLC include: (1) dyspneaand cough; (2) normal or restrictive pattern ventilation; (3) diffuse or localreticulonodular infiltrates in the lung like interstitial fibrosis and pleural effusion onchest radiograph; (4) CT and high-resolution CT (HRCT) scans reveal a beaded chainappearance caused by uneven thickening of the interlobular septa and pleural membrane,polygonal thickening of bronchovascular bundles, and mediastinal lymphadenopathy as well. Conclusion These clinical data suggest thatany manifestations similiar to pulmonary interstitial fibrosis complicated with pleuraleffusion and paratracheal lymphadenopathy should be further differentiated from PLC byHRCT and pleural-lung tissue biopsy.

     【 Keywords 】 Pulmonarylymphangitic carcinomatosis Lung neoplasm Pulmonary interstitial fibrosis

肺淋巴管癌病(PLC)是一种以转移癌细胞在淋巴管内弥漫性生长为特征的肺内转移癌的一种特殊形式 ......

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