Poellinger Alexander, Berezowska Sabina, Myers Jeffrey Leon, Huber Adrian, Funke-Chambour Manuela, Guler Sabina, Geiser Thomas, Harari Sergio, Caminati Antonella, Zompatori Maurizio, Sverzellati Nicola
Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital of Bern, University of Bern, 3010 Bern, Switzerland.
Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 25, 1011 Lausanne, Switzerland.
Diagnostics (Basel). 2022 Apr 8;12(4):937. doi: 10.3390/diagnostics12040937.
: Fibrosis in pulmonary Langerhans cell histiocytosis (PLCH) histologically comprises a central scar with septal strands and associated airspace enlargement that produce an octopus-like appearance. The purpose of this study was to identify the octopus sign on high-resolution computed tomography (HRCT) images to determine its frequency and distribution across stages of the disease. : Fifty-seven patients with confirmed PLCH were included. Two experienced chest radiologists assessed disease stages as early, intermediate, or late, as well as the lung parenchyma for nodular, cystic, or fibrotic changes and for the presence of the octopus sign. Statistical analysis included Cohen's kappa for interrater agreement and Fisher's exact test for the frequency of the octopus sign. : Interobserver agreement was substantial for the octopus sign (kappa = 0.747). Significant differences in distribution of the octopus sign between stages 2 and 3 were found with more frequent octopus signs in stage 2 and fewer in stage 3. In addition, we only found the octopus sign in cases of nodular und cystic lung disease. : The octopus sign in PLCH can be identified not only on histological images, but also on HRCT images. Its radiological presence seems to depend on the stage of PLCH.
肺朗格汉斯细胞组织细胞增多症（PLCH）中的纤维化在组织学上表现为中央瘢痕伴间隔条索及相关气腔扩大，呈现出章鱼样外观。本研究的目的是在高分辨率计算机断层扫描（HRCT）图像上识别章鱼征，以确定其在疾病各阶段的出现频率和分布情况。
纳入了57例确诊为PLCH的患者。两名经验丰富的胸部放射科医生评估疾病阶段为早期、中期或晚期，同时评估肺实质的结节、囊性或纤维化改变以及章鱼征的存在情况。统计分析包括用于评估观察者间一致性的Cohen's kappa系数以及用于章鱼征出现频率的Fisher精确检验。
观察者间对章鱼征的一致性较高（kappa = 0.747）。在2期和3期之间发现章鱼征的分布存在显著差异，2期章鱼征出现频率更高，3期较少。此外，我们仅在结节性和囊性肺病病例中发现了章鱼征。
PLCH中的章鱼征不仅可以在组织学图像上识别，也可以在HRCT图像上识别。其放射学表现似乎取决于PLCH的阶段。
