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《Chinese Journal of Medical Imaging Technology》 2009-08
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Analysis of single pulmonary tuberculous thick-walled cavity misdiagnosed as peripheral lung cancer cavity on CT

LI Bang-guo1,MA Da-qing2,LIU Ye1,HAN Hong1,GUAN Jing1,LUO Ke-jin1,XIAN Zheng-yuan1(1.Department of Radiology,the First Affiliated Hospital of Zunyi Medical College,Zunyi 563003,China;2.Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)  
Objective To analyze single pulmonary tuberculous thick-walled cavity misdiagnosed as peripheral lung cancer cavity on CT. Methods Clinical data and CT findings of 16 patients with single pulmonary tuberculous thick-walled cavity proven pathologically were retrospectively analyzed. Results Among 16 patients,11 were over 40 years old. Diameter of the cavities in 8 patients was 2—4 cm,while thickness of the cavitary walls in 9 patients was 5—15 mm. The sublobe and spicule sign of outer margin of cavity were found in 10 patients,uneven inner wall in 6 patients,with mediastinal and pulmonary hilar lymph nodes enlargement in 6 patients,pleural effusion in 5,pericardial effusion in 3 and destruction of thoracic skeleton in one patient. Ten patients underwent contrast-enhanced CT scan,and the differences of CT values before and after contrast injection were more than 26 HU in 3 patients. Conclusion The main cause of misdiagnosis lies on overemphasizing the common CT characteristics of peripheral lung cancer cavities. Reasonable and consummate CT scan program is the premise for correct diagnosis. It is a guarantee to reduce CT misdiagnosis rate by means of improving understanding of basic CT features of single pulmonary tuberculous thick-walled cavity and peripheral lung cancer cavity.
【CateGory Index】: R521;R816.4
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