Paraseptal amfizem

Özet

Paraseptal amfizem, plevra komşuluğundaki pulmoner lobüllerde, subplevral parankim ve gaz alışverişi yapan asinüslerin periferik yıkımıyla karakterizedir. İnce kesit BT'de subplevral bölgelerde yoğunlaşan kistik boşluklar paraseptal amfizem, bül veya bal peteği ile ilişkili olabilir. Subplevral paraseptal lezyonlar ve büller spontan pnömotoraksla ilişkili olabilir; bül pnömotoraksla karışabileceğinden akciğer kenarları dikkatle değerlendirilmelidir. Bül pnömotoraksla karışabileceğinden akciğer kenarları dikkatle değerlendirilmeli ve tanı toraks BT ile doğrulanmalıdır.

Faz ve pencere

HRCT tanısal

İnce kesit bilgisayarlı tomografide, plevra ve interlobüler septalar boyunca uzanan düşük atenüasyonlu alanlar veya bal peteği benzeri kistik yapılar olarak izlenir.

Önerilen pencereler: Akciğer (G 1500 / M -600).

BT bulguları

• Paraseptal amfizem, pulmoner lobüllerin plevral yüzeye komşu bölümlerini etkiler.
• Plevra yakınındaki kümelenmiş kistik boşluklar paraseptal amfizem, bül veya bal peteği ile ilişkili olabilir.
• Üst lob apeksinde sık görülen paraseptal amfizem, sekonder lobülün periferindeki konumuyla karakterizedir.
• Büyük amfizematöz büller komşu akciğer parankimine bası yapabilir.
• Paraseptal değişiklik sentrilobüler amfizemle aynı incelemede birlikte bulunabilir.
• Paraseptal amfizem ve bül varlığında pnömotoraks ayrımında akciğer kenarları ve toraks BT bulguları değerlendirilmelidir.
• Subplevral bölgelerde daha yoğun görülen kistik boşluklar paraseptal amfizem, bül veya bal peteğini temsil edebilir.

Ölçütler ve sınıflamalar

Anatomik amfizem alt tipleri

Paraseptal amfizem plevra yüzeyine komşu pulmoner lobülleri, sentrilobüler amfizem sekonder lobülün merkezini, panlobüler amfizem ise sekonder lobülün tümünü homojen biçimde etkiler.

Normalde

Subplevral lucensilerin dağılımını daha derin parankimdeki kistik alanlarla karşılaştırın.

Ayırıcı tanı

Sentrilobüler amfizem

sekonder lobülün merkezi kısmında, solunum bronşiyollerinin çevresinde genişlemiş hava boşluklarıyla karakterizedir.

Plevral bleb

plevra ile ilişkili küçük hava çıkıntısıdır; komşu parankimde belirgin yaygın amfizem olmayabilir.

Bül pnömotoraksla karışabileceğinden akciğer kenarları değerlendirilmeli; tanı belirsizse toraks BT ile doğrulanmalıdır.

Akciğer kisti

belirgin ve düzenli duvarlı, parankim içinde sınırlı hava boşluğudur; çevresinde amfizem olmak zorunda değildir.

Bal peteği, subplevral kistik boşluklarla görülebilir ve paraseptal amfizem ile büllerle ayırıcı tanıda değerlendirilmelidir.

Tuzaklar

• Bül pnömotoraksla karışabileceğinden akciğer kenarları dikkatle değerlendirilmeli ve tanı toraks BT ile doğrulanmalıdır.
• Subplevral kistik saydamlıklar tek başına paraseptal amfizemi göstermez; bal peteği ve büller de bu dağılımda görülebilir.
• Bal peteği ve paraseptal amfizem her ikisi de subplevral olabilir; retiküler fibrozis, traksiyon bronşektazisi ve mimari bozulma fibrotik kistik değişiklik lehinedir.

Kendini dene

1. Apikalde plevraya yaslanan bir sıra ince lucensi ve komşu parankimde hafif yıkım görülüyor. Plevra yüzeyine komşu pulmoner lobülleri etkileyen amfizem alt tipi hangisidir?

   • Paraseptal amfizem
   • Sentrilobüler amfizem
   • Pulmoner Langerhans hücreli histiyositoz
   • Bal peteği
   Cevabı göster

   Paraseptal amfizem. Plevra/septa boyunca sıralı lucensiler paraseptal dağılıma uyar. Plevra yüzeyine komşu pulmoner lobülleri etkileyen patern paraseptal amfizemdir.

2. Paraseptal amfizem hangi plevral komplikasyona yatkınlık oluşturur?

   • Pnömotoraks
   • Bül içi sıvı
   • Plevral plak
   • Lober atelektazi
   Cevabı göster

   Pnömotoraks. Paraseptal amfizem pnömotoraksa yatkınlık oluşturur.

İlgili konular

• Sentrilobüler amfizem
• Panlobüler amfizem
• Büllöz amfizem
• Hava hapsi ve mozaik atenüasyon

Kaynaklar

Bu sayfadaki 34 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 26 cümle bu karşılaştırmada düzeltildi (2026-10-09).

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