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1、.,1,肺泡上皮不典型腺瘤样增生,.,2,肺泡上皮不典型腺瘤样增生(atypical adenomatous hyperplasia ,AAH),是指细胞沿着细支气管肺泡壁增生形成的,文献中该类病变出现的名称众多 ,如不典型肺泡(或肺泡不典型) 细胞增生、不典型细支气管肺泡细胞增生、细支气管肺泡上皮增生以及细支气管肺泡细胞腺瘤。,.,3,有的认为它仅是损伤后再生修复性增生,而另外一些学者认为它是损伤刺激后造成的,并由此导致细支气管肺泡癌(Bronchioloalveolar lung carcinoma ,BAC)的发生,因此认为AAH 是BAC 的癌前病变,甚至有学者认为是BAC 的早期癌。
2、,发病机制,.,4,AAH 细胞形态上类似于Clara 细胞或型肺泡细胞,呈立方形或矮柱状,肺泡壁因纤维化或淋巴细胞浸润而轻度增厚。,镜下观察,.,5,aHistological appearance of a low-grade (AAH) b high-grade AAH c early adenocarcinoma(AC) d overt AC,.,6,无典型和特征性性影像学表现,偶在体检中发现,主要依赖HRCT。 类圆形结节,直径大多6mm到15mm不等,一般不超过10mm,密度较均匀,形态较规则,边界较清楚。,影像学检查,.,7,computed tomography of ches
3、t shows a solitary nodular atypical adenomatous hyperplasia .the lesion appeared as around nodule with ground-glass opacity .note the smooth and distinct borders of the nodule .note aslo the absence of pleural.,.,8,histopathological findings :atypical epithelial cell proliferation along slightly thickened alveolar septa,.,9,one case(72-year-old female).chest CT shows a solitary nodule with a homogeneous ground-glass opacity .note the absence of convergence of pulmonary,.,10,细支气管肺泡癌 结核球 炎性假瘤 局部特发性肺间质纤维化 硬化性血管瘤,鉴别诊断,.,11,细支气管肺泡癌,.,12,.,13,谢谢,/10/29,.,14,