結(jié)節(jié)病影像學(xué)特點(diǎn)英文

1、Pulmonary Sarcoidosis: Typical Manifestations at High- Resolution CT with Pathologic Correlation,Recent Advances in Sarcoidosis,結(jié)節(jié)病CT典型表現(xiàn)結(jié)節(jié)病進(jìn)展,Sarcoidosis is a multisystem disorder that is characterized by noncaseous ep

2、ithelioid cell granulomas, which may affect almost any organ. 結(jié)節(jié)病是一種以非干酪樣壞死的上皮細(xì)胞肉芽腫為特點(diǎn)的多系統(tǒng)疾病，幾乎可以累及所有器官。,Sarcoidosis may be asymptomatic or chronic. It commonly improves or clears up spontaneously（自愈或好轉(zhuǎn)）. More than 2

3、/3 of people with lung sarcoidosis have no symptoms after 9 years. About 50% have relapses. About 10% develop serious disability.,Sarcoidosis of the lung is primarily an interstitial lung disease in which the inflammat

4、ory process involves the alveoli, small bronchi, and small blood vessels.,Typical and Atypical Features of Pulmonary Sarcoidosis at High-Resolution CT Typical features 1 Lymphadenopathy: hilar, mediastinal (right

5、 paratracheal), bilateral, symmetric, and well defined 2 Nodules: micronodules (2–4 mm in diameter; well defined, bilateral); macronodules (≥5 mm in diameter, coalescing) 3 Lymphangitic spread: peribronchova

6、scular, subpleural, interlobular septal 4 Fibrotic changes: reticular opacities, architectural distortion, traction bronchiectasis, bronchiolectasis, volume loss Bilateral perihilar opacities 5 Predo

7、minant upper- and middle-zone locations of parenchymal abnormalities,結(jié)節(jié)病原本是肺間質(zhì)性病變，累及肺泡，支氣管和小血管,淋巴結(jié)增大，兩側(cè)對(duì)稱，境界清楚,大小結(jié)節(jié),淋巴管播散，支氣管血管鞘，胸膜下，小葉間隔,纖維化改變，網(wǎng)狀陰影，肺結(jié)構(gòu)扭曲，牽拉性支擴(kuò)，肺容積縮小，兩肺門旁致密影,中上肺為主,典型特征,Pathologic Correlation 相關(guān)病理

8、 Granulomas in the lung parenchyma have a characteristic distribution in relation to lymphatics in the peribronchovascular interstitial space, subpleural interstitial space, and, to a lesser extent, the interlobular s

9、epta (ie, a lymphangitic distribution)肺實(shí)質(zhì)肉芽腫分布與支氣管血管鞘，胸膜下結(jié)締組織，小葉間隔中淋巴管相關(guān)Thickened bronchovascular bundles and small perivascular nodules seen at CT corresponded to granulomas within the connective tissue sheath surro

10、unding pulmonary airways and vessels. Pleural or subpleural nodules were correlated with granulomas adjacent to the visceral pleuraCT上支氣管血管鞘增厚和小結(jié)節(jié)是與包繞氣道血管結(jié)締組織鞘中肉芽腫，胸膜和胸膜下結(jié)節(jié)與臟層胸膜旁肉芽腫相關(guān)。,Ground-glass opacities represe

11、nted an accumulation of many granulomatous lesions, with or without fibrosis, in the alveolar septa and around the small vessels. No alveolitis was seen 肺泡間隔小血管周圍大量肉芽腫是毛玻璃陰影主要原因，可伴纖維化，但沒(méi)有肺泡炎。Large parenchymal nod

12、ules (>1 cm in diameter) represented coalescent granulomas 大結(jié)節(jié)是肉芽腫病變的融合 Air bronchiolograms within regions of dense consolidation on CT images corresponded to bronchiolar dilatation with surrounding fibros

13、is 支氣管充氣癥是纖維化旁的支擴(kuò)honeycomb-like pattern of microscopic cysts seen at pathologic analysis. 蜂窩樣改變?cè)陲@微鏡下就是很多的小囊,pulmonary sarcoidosis shows the typical perilymphatic distribution of micronodules (arrow

14、). （外周淋巴分布的微結(jié)節(jié)） Photomicrograph of a lung biopsy specimen demonstrates numerous epithelioid granulomas (arrow) surrounding the bronchial walls and immed

15、iately beneath the normal bronchial epithelium (arrowheads).,CT scan shows multiple micronodules with a peribronchovascular distribution in both lungs, predominantly in the upper and middle lobes. One cluster of nodules

16、in the periphery of the left upper lobe (arrow) has coalesced to form a conglomerate lesion (macronodule). Coronal reformatted image from high-resolution CT clearly shows upper-lobe predominance of the micronodules.

17、 Low-magnification photomicrograph,slice from the lower part of the right upper lobe shows multiple confluent granulomas infiltrating the peribronchovascular (arrows) and subpleural (arrowheads) interstitium.,CT sca

18、n shows mediastinal lymph node enlargement and a reticular pattern produced by nodularity and thickening of interlobular septa, pleural surfaces, and fissures, CT掃描顯示縱隔淋巴結(jié)腫大和形成網(wǎng)狀圖案的小葉間隔增厚，及胸膜表面，及產(chǎn)生的裂縫。 (b) Photomicrogra

19、ph of a specimen from fine-needle aspiration biopsy of an enlarged right paratracheal lymph node shows a group of histiocytes against a lymphocytic background, a cytologic structure characteristic of sarcoid granuloma.

20、(c) Photomicrograph of a lung biopsy specimen from another patient shows progressive thickening of the interlobular septum (*) because of the accumulation of numerous sarcoid granulomas (arrowheads), an appearance that

21、correlates well with the CT features seen in a. 從擴(kuò)大的右氣管旁淋巴結(jié)細(xì)針穿刺活檢標(biāo)本顯微鏡下顯示一組以淋巴細(xì)胞的背景的組織細(xì)胞，具有結(jié)節(jié)病肉芽腫細(xì)胞的結(jié)構(gòu)特征。（C）從另一個(gè)病人的肺活檢標(biāo)本的顯微照片顯示小葉間隔增厚（*），大量積累的肉芽腫結(jié)節(jié)（箭頭）。,,. (11a) CT scan shows a diffuse ground-glass pattern produced by

22、multiple confluent micronodules, with associated bronchiectasis. CT掃描顯示彌漫性磨玻璃影，由多個(gè)融合的結(jié)節(jié)產(chǎn)生，伴支氣管擴(kuò)張 (11b) Magnified axial high-resolution CT scan of the right lung clearly depicts separate nodules in a subpleural (black arr

23、ow) and fissural (white arrow) distribution and along the bronchovascular bundles (arrowheads) 放大的軸位高分辨率CT掃描清楚顯示右肺胸膜下區(qū)分胸膜下的結(jié)節(jié)（黑色箭頭）和沿支氣管血管束分布的“裂”（白色箭頭）. (11c) High-power photomicrograph shows an accumulation of intersti

24、tial granulomas (white *), which causes a thickened appearance of the interalveolar septa, and acinar granulomas (black *), which form in the interstitium of the alveolar wall and protrude into the alveoli (arrowheads).

25、高倍鏡下涂片顯示間質(zhì)肉芽腫集聚（白*），使肺小泡壁的增厚，和腺泡肉芽腫（黑色），形成在肺泡壁的間質(zhì)和伸入肺泡（箭頭）。,Typical (a, b) and atypical (c, d) radiologic findings of lymphadenopathy in four patients with sarcoidosis四例結(jié)節(jié)病淋巴結(jié)病變的影像學(xué)表現(xiàn). (a) Axial contrast material–enhance

26、d CT scan (mediastinal window) shows typical bilateral and symmetric hilar (ar- rows) and subcarinal (*) lymphadenopathy.CT增強(qiáng)掃描（縱隔窗）顯示了典型的雙側(cè)對(duì)稱性肺門（箭頭）及隆突下淋巴結(jié)腫大（*） (b) Axial unenhanced CT scan (mediastinal window) obtained

27、 at the level of the left pulmonary artery shows enlargement of right paratracheal and left hilar lymph nodes (arrows) 右氣管旁和左肺門淋巴結(jié)腫大. Although the right hilum is not shown, it too was affected. (c) Axial unenhanced CT sc

28、an (mediastinal window) shows punctate cal- cifications of hilar lymph nodes (arrows), a pattern that also occurs in other chronic granulomatous diseases. (d) Axial contrast-enhanced CT scan shows bilateral eggshell-like