Bildgebende Diagnostik der pulmonalen Lymphangiosis carcinomatosa
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Zusammenfassung
Die Diagnose der pulmonalen Lymphangiosis carcinomatosa (PLC) ist für die prognoseorientierte Therapiestratifikation von Tumorpatienten von hoher Bedeutung. Bildgebend ist die High-resolution-Computertomographie (HRCT) state of the art. Durch Detailauflösung der Parenchymstrukturen ist eine Charakterisierung interstitieller Verschattungsmuster mit HRCT möglich, während die vorgeschaltete Röntgenthoraxübersicht sie detektiert und andere Erkrankungen ausschließt. Es werden die typischen Zeichen der PLC unter besonderer Berücksichtigung der HR-Phänomenologie erläutert und unter Abgleichung mit Literaturangaben in Bezug auf Anatomie und Pathogenese differenzialdiagnostisch diskutiert und mit Befundbeispielen unterlegt.
Schlüsselwörter
Pulmonale Lymphangiosis carcinomatosa Diagnose Röntgen-Thorax High-resolution-CTDiagnostic imaging of pulmonary lymphangiosis carcinomatosa
Abstract
The diagnosis of pulmonary lymphangiosis carcinomatosa (PLC) is of great importance for the prognostically-oriented therapy stratification of tumor patients. In this field, high-resolution computed tomography (HRCT) is the state of the art in imaging. Using HRCT, it is possible to identify pulmonary parenchymal structures in a detailed fashion to evaluate interstitial patterns. This step is preceded by an x-ray of the thorax that detects pathological findings and rules out other diseases. The typical characteristics of PLC are described with particular attention to HR-phenomenology, and discussed in comparison with the literature regarding anatomy and pathogenesis. Finally, conclusions are drawn for differential diagnosis and supported by characteristic cases.
Keywords
Pulmonary lymphangiosis carcinomatosa Diagnosis Chest radiography High-resolution CTNotes
Danksagung
Für die internistisch-pulmologische Beratung zu den klinischen Ausführungen danke ich Herrn Dr. Andreas Franke (Pneumologische Klinik des FLT).
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