Giron J, Tawil A, Trussard V, Serre-Cousiné O, Bousquet C, Senac J P, Durand G, Benezet O, Chanez P, Godard P
Service de Radiologie Thoracique, CHU Montpellier, Hôpital Saint-Charles.
Ann Radiol (Paris). 1990;33(1):31-8.
The authors studied the value of high resolution computed tomography in twelve patients with pulmonary histiocytosis X. The aim of this study was to define the CT signs. More or less thin-walled air-filled cysts were observed in all but one case, although the subsequent follow-up of this case revealed the development of such cysts 6 months later. Nodules were also present in all but two cases. They sometimes consisted of excavated nodules. Reticulations, "frosted glass" appearance and irregularities of interface--all signs of a classical interstitial syndrome--were observed less frequently. The lesions were always diffuse, cortical and medullary. The predominance for the upper lobes was only observed in 50% of cases. The case examined on 2 occasions during the course of the disease at an interval of 6 months suggested the progression of small solid nodules towards larger, excavated nodules, finally resulting in thin-walled cysts which may eventually coalesce to force a "lacework" appearance. The pathophysiology of this progression of the lesions and therefore of the pulmonary eosinophilic granuloma is discussed by the authors.
作者研究了高分辨率计算机断层扫描在12例肺组织细胞增多症X患者中的价值。本研究的目的是明确CT征象。除1例患者外，其他所有患者均观察到或多或少的薄壁含气囊肿，尽管该病例随后的随访显示6个月后出现了此类囊肿。除2例患者外，其他患者也均有结节。结节有时由空洞结节组成。网状影、“磨砂玻璃”样表现及界面不规则——所有典型间质性综合征的征象——较少被观察到。病变总是弥漫性的，累及皮质和髓质。仅50%的病例观察到上叶为主。在疾病过程中间隔6个月对1例患者进行了2次检查，结果显示小实性结节逐渐发展为更大的空洞结节，最终形成薄壁囊肿，最终可能融合成“网状”外观。作者讨论了病变进展以及因此肺嗜酸性肉芽肿的病理生理学。
