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影像学表现为簇性微结节聚集征的肺结核一例
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- Author:
- No author available
- Journal Title:
- Chinese Journal of Tuberculosis and Respiratory Diseases
- Issue:
- 9
- DOI:
- 10.3760/cma.j.issn.1001-0939.2016.09.022
- Key Word:
- No keyword available
Abstract： 患者男,24岁.常规体检X线胸片发现多发小结节影,无发热、咳嗽、咳痰及呼吸困难等.于2012年9月来我院门诊.既往体健.体检未发现阳性体征.血常规、C反应蛋白、ESR、肺炎支原体抗体滴度、癌胚抗原、细胞角蛋白19、神经元特异性烯醇化酶及3次痰找抗酸杆菌均未见异常,外院胸部螺旋CT检查提示弥漫性渗出性改变,可见“铺路石”征,纵隔淋巴结稍大.支气管镜检查示气管及4级以内支气管管腔通常,黏膜光滑,未见新生物、异物及活动性出血.分别于右上叶和左下叶行支气管肺泡灌洗,BALF澄清,送至我市某大型医院行病理诊断,示重度慢性炎症伴少量变性物,PAS染色阳性,结合临床表现符合肺泡蛋白沉积症.2周后在我院门诊就诊,胸部高分辨率CT示双肺弥漫性簇性微结节聚集,多量树芽征,呈地图状分布.纵隔淋巴结肿大(图1,2).
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