第 188 期 写在前面 Fleischner Society分别于1984年和1996年在AJR和Radiology上发布了两版有关胸部影像成像术语的白皮书,前者主要针对胸部普通放射学,后者针对CT胸部成像。由于CT在临床上的广泛应用,对胸部疾病的研究更加深入,2008年Fleischner Society对胸部成像术语进行了全面的更新,并一直使用至今。为方便学子们学习,本刊按白皮书上字母的顺序分期双语连载,全部术语加起来约100个,最后集成总册,供大家查阅。 organizing pneumonia 机化性肺炎 Pathology(英) — Organizing pneumonia manifests as a histologic pattern characterized by loose plugs of connective tissue in the airspaces and distal airways. Interstitial inflammation and fibrosis are minimal or absent. Cryptogenic organizing pneumonia, or COP, is a distinctive clinical disorder among the idiopathic interstitial pneumonias (5), but the histologic pattern of organizing pneumonia is encountered in many different situations, including pulmonary infection, hypersensitivity pneumonitis, and collagen vascular diseases. 病理(中) — 机化性肺炎OP的组织学形态特征为肺含气空间(肺泡)和终末气道内出现结缔组织的疏松嵌塞。间质炎症和纤维化轻微或无。隐源性机化性肺炎,或称为COP,在特发性间质性肺炎中是一种特别的临床疾病,但机化性肺炎的组织学形态可出现在许多不同的情况中,包括肺部感染,过敏性肺炎,以及胶原性血管疾病。
Radiographs and CT scans(英) — Airspace consolidation is the cardinal feature of organizing pneumonia on chest radiographs and CT scans. In COP, the distribution is typically subpleural and basal (Fig 45) and sometimes bronchocentric (96). Other manifestations of organizing pneumonia include ground-glass opacity, tree-in-bud pattern, and nodular opacities (37). X线成像与CT扫描(中) — 在胸片和CT扫描上,肺含气空间(编者按:包括肺泡+肺泡管+呼吸性支气管)实变是机化性肺炎的基本特征。在COP,病变的典型分布为胸膜下及肺基底部(图45),有时则呈以支气管为中心分布。机化性肺炎的其他表现包括:磨玻璃征,树芽征,以及结节影。 延伸阅读:隐源性机化性肺炎 Cryptogenic organizing pneumonia :COP Terminology Organising pneumonia (OP) is a histologic pattern of alveolar inflammation with varied aetiology (including pulmonary infection). The idiopathic form of OP is called cryptogenic organising pneumonia (COP) and it belongs to idiopathic interstitial pneumonias (IIP's). COP was previously termed bronchiolitis obliterans organising pneumonia (BOOP), not to be confused with bronchiolitis obliterans per se . 术语 机化性肺炎(OP)是各种病因引起的肺泡炎症病理改变(包括肺感染)。特发性OP称隐源性机化性肺炎(COP),并归类于特发性间质性肺炎(IIP‘s)。 COP以前称为闭塞性细支气管炎性机化性肺炎(BOOP),勿与闭塞性细支气管炎本身混淆。 流行病学:最常见于55-60岁年龄组 临床表现:可表现为短期气促史(如<2个月),非刺激性咳嗽,体重减轻,虚弱和发热等。与抽烟无关。 影像学特征 胸片:
CT扫描:最常见的HRCT表现包括:
反晕征( reverse halo sign,或称atoll sign-环状珊瑚岛征)被认为具有高度特异性,大约可在20%的COP患者中观察到这种征象。 环状珊瑚岛
此外,atoll征也被称为fairy ring-仙环征。 COP病例 1 [http:///articles/cryptogenic-organising-pneumonia] COP病例2——本例可见反晕征 词典分隔线 A [7] aortopulmonary window主肺动脉窗 [9] architectural distortion 结构变形 [11] azygoesophageal recess奇静脉食管隐窝 B C [25] centrilobular emphysema 小叶中央性肺气肿 [27] crazy-paving pattern 铺路石征 [28+] collapse 毁陷,参考? [10]-atelectasis D-H [30] diffuse alveolar damage, or DAD弥漫性肺泡破坏,参考? [2]- AIP [33] folded lung 皱襞样肺 / 见 rounded atelectasis. [34] fungus ball 曲菌球 / 见 mycetoma. [35] gas trapping 气体潴留/见 air trapping. [36] ground-glass nodule 磨玻璃结节 /见 nodule. [37] ground-glass opacity 磨玻璃影 I-J [41] idiopathic pulmonary fibrosis 特发性肺纤维化 [44] interlobular septal thickenin 小叶间隔增厚 [46] interstitial emphysema 间质性肺气肿 L-M [52] lobular core structures小叶核心结构 [55] lymphoid interstitial pneumonia, or LIP 淋巴间质性肺炎 [57] mediastinal compartments纵隔分区 [60] mosaic attenuation pattern马赛克征 N-O 本文编辑:伍筱梅 广州医科大学附属第一医院 |
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