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320例1型人类嗜T淋巴细胞病毒携带者的肺部CT表现

Pulmonary CT findings in 320 carriers of human T-lymphotropic virus type 1.

作者信息

Okada Fumito, Ando Yumiko, Yoshitake Sachie, Yotsumoto Shinji, Matsumoto Shunro, Wakisaka Masaki, Maeda Toru, Mori Hiromu

机构信息

Department of Diagnostic and Interventional Radiology, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita 879-5593, Japan.

出版信息

Radiology. 2006 Aug;240(2):559-64. doi: 10.1148/radiol.2402050886.

Abstract

PURPOSE

To retrospectively evaluate pulmonary computed tomographic (CT) findings in human T-lymphotropic virus type 1 (HTLV-1) carriers, who were characterized by means of polyclonal integration of proviral DNA.

MATERIALS AND METHODS

Institutional review board approval was obtained, and informed consent was waived. Chest CT scans obtained between January 1996 and October 2004 in 320 (154 men, 166 women; age range, 31-86 years; mean, 64 years) patients with HTLV-1 were retrospectively evaluated by three chest radiologists. Parenchymal abnormalities (ground-glass opacity, consolidation, centrilobular nodules, thickening of bronchovascular bundles, interlobular septal thickening, and bronchiectasis) were evaluated, along with enlarged lymph nodes and pleural effusion. In 58 patients who underwent surgical biopsy or transbronchial biopsy, comparison of CT images with the actual specimens was performed by a pathologist and three chest radiologists.

RESULTS

On CT scans, abnormal findings were seen in 98 (30.1%) patients and consisted of centrilobular nodules (n = 95), thickening of bronchovascular bundles (n = 55), ground-glass opacity (n = 51), bronchiectasis (n = 50), interlobular septal thickening (n = 28), and consolidation (n = 5). These abnormalities were predominantly seen in the peripheral lung parenchyma (n = 70). Pathologically, these findings corresponded to lymphocytic infiltration along respiratory bronchioles and bronchovascular bundles. Pleural effusion and enlarged lymph nodes were found in two and five patients, respectively.

CONCLUSION

CT findings in patients with HTLV-1 consisted mainly of centrilobular nodules, ground-glass opacity, and thickening of the bronchovascular bundles in the peripheral lung. These CT findings are considered suggestive of thoracic involvement in patients with HTLV-1.

摘要

目的

回顾性评估1型人类嗜T淋巴细胞病毒(HTLV-1)携带者的肺部计算机断层扫描(CT)表现,这些携带者通过前病毒DNA的多克隆整合进行特征描述。

材料与方法

获得机构审查委员会批准,并免除知情同意。对1996年1月至2004年10月期间320例(154例男性,166例女性;年龄范围31 - 86岁;平均64岁)HTLV-1患者的胸部CT扫描进行回顾性评估,由三位胸部放射科医生进行评估。评估实质异常(磨玻璃影、实变、小叶中心结节、支气管血管束增厚、小叶间隔增厚和支气管扩张)以及肿大淋巴结和胸腔积液。对58例行手术活检或经支气管活检的患者,由一名病理学家和三位胸部放射科医生将CT图像与实际标本进行对比。

结果

在CT扫描中,98例(30.1%)患者有异常表现,包括小叶中心结节(n = 95)、支气管血管束增厚(n = 55)、磨玻璃影(n = 51)、支气管扩张(n = 50)、小叶间隔增厚(n = 28)和实变(n = 5)。这些异常主要见于肺外周实质(n = 70)。病理上,这些表现对应于沿呼吸细支气管和支气管血管束的淋巴细胞浸润。分别在2例和5例患者中发现胸腔积液和肿大淋巴结。

结论

HTLV-1患者的CT表现主要为小叶中心结节、磨玻璃影和肺外周支气管血管束增厚。这些CT表现被认为提示HTLV-1患者存在胸部受累。

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