【呼吸系统】错构瘤 | Hamartoma

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【错构瘤】

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1

病史

78/M, Incidentally found lung nodule in routine health check-up.

78岁男性，常规体检偶发肺部结节。

2

影像学检查

图1 胸部CT增强纵隔窗

图2 胸部CT增强肺窗

图3 PET-CT

3

影像学表现

On chest CT scan, a well-defined nodule is seen in the right upper lobe. 
胸部CT显示右肺上叶结节，边界清晰。

A focal low attenuated portion is noted in the anterior part of the lesion. 

病灶前部见一局灶性低密度区。

On PET-CT scan, the nodule does not show hypermetabolism.

PET-CT显示结节未见高摄取。

4

诊断

Hamartoma
错构瘤

5

诊断要点

In the lung, the hamartoma traditionally refers to a well-defined tumor consisting predominantly of cartilage and adipose tissue. It can occur within the lung parenchyma or in an endobronchial location.

肺错构瘤传统是指主要由软骨和脂肪组织组成的肿瘤，边界清楚。可以发生在肺实质或支气管内。

Radiologically, pulmonary hamartomas typically are well-defined, solitary nodules without lobar predilection. The majority are smaller than 4cm in diameter, although some occasionally grow to a very large size.
肺错构瘤通常是边界清楚的孤立结节，无明显分叶。大多数的直径小于4cm，少数为较大的肿块影。

When calcification is present, however, the roentgenographic pattern most often resembles popcorn.
部分病变内可见钙化，典型的征象为爆米花样。

The presence of fat and calcium make the CT diagnosis exquisitely accurate.
脂肪及钙化使诊断更为准确。

Thin sections must be used to identify fat with certainty. On thicker sections, a small cavity may be confused with fat because of partial volume averaging.
脂肪成分必须用薄层来确定。在厚层图像，小的腔隙可能由于部分容积效应与脂肪混淆。

In the absence of the characteristic calcification or fat, the differential diagnosis includes all other solitary pulmonary nodules, particularly carcinoma.
无钙化或脂肪成分的病灶，需与其他孤立性结节鉴别，特别是癌。

well-defined：边界清楚的

cartilage [ˈkɑ:tɪlɪdʒ] n.<解>软骨;软骨结构

lung parenchyma：肺实质

endobronchial：支气管内的

calcification：钙化

popcorn calcification：爆米花样钙化

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