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1、PulmonarySarcoidosis:TypicalandAtypicalManifestationsatHigh-ResolutionCTwithPathologicCorrelationRecentAdvancesinSarcoidosisChest2011;139;结节病CT典型和不典型表现结节病进展OrganLungPleuraLymphNodesSkinEyeNasalMucosa(鼻粘膜)Larynx(喉)BoneMarrowSpleenLiver%901-575-90252520515-4050-6060-90OrganKidneyCalciumMetabolismNer
2、vousSystemBoneJointsHeartEndocrineGlandsParotidGlandGastrointestinalSystem%Rare1-25525-505Rare10RareSarcoidosisisamultisystemdisorderthatischaracterizedbynoncaseousepithelioidcellgranulomas,whichmayaffectalmostanyorgan.结节病是一种以非干酪样坏死的上皮细胞肉芽肿为特点的多系统疾病,几乎可以累及所有器官。Sarcoidosismaybeasymptomaticorchronic
3、.Itcommonlyimprovesorclearsupspontaneously(自愈或好转).Morethan2/3ofpeoplewithlungsarcoidosishavenosymptomsafter9years.About50%haverelapses.About10%developseriousdisability.Sarcoidosisofthelungisprimarilyaninterstitiallungdiseaseinwhichtheinflammatoryprocessinvolvesthealveoli,smallbronchi,andsmallblood
4、vessels.TypicalandAtypicalFeaturesofPulmonarySarcoidosisatHigh-ResolutionCTTypicalfeatures1Lymphadenopathy:hilar,mediastinal(rightparatracheal),bilateral,symmetric,andwelldefined2Nodules:micronodules(2–4mmindiameter;welldefined,bilateral);macronodules(≥5mmindiameter,coalescing)3Lymphangiticspread:
5、peribronchovascular,subpleural,interlobularseptal4Fibroticchanges:reticularopacities,architecturaldistortion,tractionbronchiectasis,bronchiolectasis,volumelossBilateralperihilaropacities5Predominantupper-andmiddle-zonelocationsofparenchymalabnormalities结节病原本是肺间质性病变,累及肺泡,支气管和小血管淋巴结增大,两侧对称,境界清楚大小结节淋
6、巴管播散,支气管血管鞘,胸膜下,小叶间隔纤维化改变,网状阴影,肺结构扭曲,牵拉性支扩,肺容积缩小,两肺门旁致密影中上肺为主典型特征Atypicalfeatures1Lymphadenopathy:unilateral,isolated,anteriorandposteriormediastinal2Airspaceconsolidation:masslikeopacities,conglomeratemasses,solitarypulmonarynodules,confluentalveolaropacities(alveolarsarcoidpattern)3Ground-glasso
7、pacities4Linearopacities:interlobularseptalthickening,intralobularlinearopacities5Fibrocysticchanges:cysts,bullae,blebs,emphysema,honeycomb-likeopacitieswithupper-andmiddle-zonepredominance单侧孤立前后纵隔淋巴结增大肺泡实变:肿块,实质