Pulmonary and Critical Care Medicine, Geisinger, 100 North Academy Avenue, Danville, PA 17822-1334, USA.
Pulmonary and Critical Care Medicine, Geisinger, 100 North Academy Avenue, Danville, PA 17822-1334, USA.
Clin Chest Med. 2018 Sep;39(3):505-513. doi: 10.1016/j.ccm.2018.04.004.
Pulmonary artery filling defects can be observed in various pathologic processes other than pulmonary embolism, for example, nonthrombotic pulmonary embolism with biological and nonbiological materials and intrinsic pulmonary artery lesions. They have also been described in rare conditions, such as fibrosing mediastinitis and congenital absence or stenosis of pulmonary artery, and some pulmonary parenchymal and airway malignancies. Misdiagnosis is common owing to the relative rarity of these conditions. Correct diagnosis is based on the appropriate clinical suspicion considering the unique clinical features, laboratory findings, and additional radiologic clues inferring a pathology other than pulmonary embolism.
除了肺栓塞之外，各种病理过程中也可以观察到肺动脉充盈缺损，例如，生物和非生物材料引起的非血栓性肺栓塞以及固有肺动脉病变。这些情况在罕见情况下也有描述，如纤维性纵隔炎和肺动脉先天缺失或狭窄，以及一些肺实质和气道恶性肿瘤。由于这些情况相对罕见，因此误诊很常见。正确的诊断基于适当的临床怀疑，考虑到独特的临床特征、实验室发现以及提示除肺栓塞以外的病理学的其他放射学线索。
