Nishimura K, Itoh H, Kitaichi M, Nagai S, Izumi T
Chest Disease Research Institute, Kyoto University, Japan.
Semin Ultrasound CT MR. 1995 Oct;16(5):361-70. doi: 10.1016/0887-2171(95)90025-x.
In CT the presence of mediastinal or hilar lymphadenopathies and thickened bronchovascular bundles are landmarks for the diagnosis of pulmonary sarcoidosis. The major CT findings for parenchymal involvement are thickened bronchovascular bundles, large parenchymal nodules, pleural or subpleural nodules, ground-glass opacities, local lung volume loss (distortion of the lung parenchyma), and microscopic and macroscopic honeycombing. The thickened bronchovascular bundles correspond histologically to granulomas, either with or without perigranulomatous fibrosis in the connective tissue sheath around the pulmonary vessels and airways. Conglomerate granulomas are represented on CT by high-attenuation nodules, and the ground-glass opacities are caused by the summation of a number of small granulomas in the interstitium.
在CT检查中，纵隔或肺门淋巴结肿大以及支气管血管束增粗是诊断肺结节病的标志。实质受累的主要CT表现为支气管血管束增粗、实质大结节、胸膜或胸膜下结节、磨玻璃影、局部肺容积缩小（肺实质变形）以及镜下和肉眼可见的蜂窝状改变。支气管血管束增粗在组织学上对应于肉芽肿，肺血管和气道周围的结缔组织鞘内可有或无肉芽肿周围纤维化。聚合性肉芽肿在CT上表现为高密度结节，磨玻璃影是由间质内多个小结节聚集所致。
