Wagner A L, Szabunio M, Hazlett K S, Wagner S G
Department of Radiology, University of South Florida College of Medicine, Tampa 33612, USA.
AJR Am J Roentgenol. 1998 Mar;170(3):723-6. doi: 10.2214/ajr.170.3.9490962.
Round pneumonia, a benign cause of coin lesions seen on chest radiography, can often be difficult to distinguish from bronchogenic carcinoma. Although relatively uncommon in adults, this entity will probably be seen in most radiology practices and may lead to CT and biopsy. Because round pneumonia is easily treated with antibiotics, this diagnosis should be considered in all patients with a coin lesion, keeping in mind that bronchogenic carcinoma is much more frequent. A recent chest radiograph with normal findings or a history of cough and fever can aid in the diagnosis. A trial of antibiotics followed by a second chest radiograph in 2-3 weeks may be indicated in symptomatic or younger patients but should be considered in all patients with a solitary pulmonary nodule, because round pneumonia can occur in patients of any age and may be clinically silent. Any patient with a pulmonary nodule that does not decrease in size or resolution after antibiotic treatment should be further assessed with bronchoscopy, transthoracic needle biopsy, or other diagnostic procedures.
圆形肺炎是胸部X线片上出现的肺部钱币状病变的一种良性病因，常常难以与支气管肺癌相鉴别。尽管在成年人中相对少见，但在大多数放射科实践中可能会遇到这种情况，并且可能会导致进行CT检查和活检。由于圆形肺炎用抗生素很容易治疗，所以对于所有有肺部钱币状病变的患者都应考虑这一诊断，要记住支气管肺癌更为常见。近期胸部X线片结果正常或有咳嗽、发热病史有助于诊断。对于有症状的患者或年轻患者，可在使用抗生素治疗后2 - 3周进行第二次胸部X线检查，所有孤立性肺结节患者都应考虑这一检查，因为圆形肺炎可发生于任何年龄的患者，且可能临床上无明显症状。任何肺部结节患者在抗生素治疗后大小未减小或未消散，都应通过支气管镜检查、经胸针吸活检或其他诊断程序进行进一步评估。
