肺部炎症新认识点滴肺部炎症炎症、肿瘤哪一个更难诊断？炎症、肿瘤、良性、恶性你的诊断准确率是多少？细菌、病毒、支原体、真菌、结核你诊断准确率又是多少？炎症诊断比肿瘤更难目前多数医院实际上肺结核肺结核肺真菌感染支原体肺炎支原体肺炎常见，可治有一定特征，部分能诊断诊断有意义支原体肺炎组织病理学表现MP影像学典型表现的解释M3M21月特征1areticulonodularpatternconfinedtotheleftlowerlobe.M6特征2F8M8，右下叶支气管壁增厚，下叶GGO实变及GGOM20月，M4M4，发热，咳嗽咳痰，呕吐腹泻F6M8F7，GGOM4，弥漫性GGO，伴网合结节结节间质性改变2d后部分吸收，遗留条状网格影M6，典型表现M9，肺不张常见，反映支气管病变肺实质坏死单侧肺门淋巴结增大7%-22%，与结核难以区分，没有特点。5%–20%出现胸腔积液，多数一过性或无明显临床意义，少数在肺内病灶吸收后仍持续一段时间。(细菌性肺炎更容易出现胸水)纵隔气肿F8，舌段不全不张M11，支原体肺炎M2，支气管壁增厚，LN大，胸水F2M8过敏性肺炎常见，易治想到，结合有关检查大多能确诊诊断有意义多数病例吸入抗原后数年后发病初始症状影像表现急性、隐匿发作不伴纤维化multifocalground-glassopacitiesintherightlung.Sparedlobules(arrow)probablyrepresentairtrapping,butexpiratoryhigh-resolutionCTimageswerenotavailableforconfirmation.Inspiratoryandexpiratorypatchyground-glassopacities,normalregions,andairtrapping.Thiscombinationoffindings,knownastheheadcheesesign,isindicativeofhypersensitivitypneumonitis.Hypersensitivitypneumonitisinaworkerinasalmonprocessingfacility.(a–c)Axialhigh-resolutionCTimagesdemonstratepatchy,vaguelycentrilobularground-glassopacitieswithrelativesparingoftheextremelungbases.(CasecourtesyofIngridPeterson,MD,VirginiaMasonMedicalCenter,Seattle,Wash.)隐匿发作伴纤维化Insidioushypersensitivitypneumonitiswithfibrosis.(a)Axialhigh-resolutionCTimagesoftheupperpartofthelungsshowpredominantreticulationwithhoneycombing,tractionbronchiectasis,andarchitecturaldistortion.(b)Axialhigh-resolutionCTimagesofthelowerpartofthelungsdemonstrateground-glassopacity,reticulation,andlobularairtrapping.(c)CoronalreformattedCTimageallowsabetterevaluationofthedistributionoftheseabnormalities.HypersensitivitypneumonitiswithimagingfeaturessimilartothoseofNSIP.(a,b)AxialCTimagesofthelowerpartofthelungs(aobtainedduringinspiration;b,duringexpiration)demonstratemildreticulationwithground-glassopacityandairtrapping(arrowsinb).(c)CoronalreformattedCTimagebetterdemonstratesthedistributionoftheseabnormalities.Progressionofinsidioushypersensitivitypneumonitistofibrosis.(a)Axialhigh-resolutionCTimageoftherightlungatth