目的探讨不典型下肺叶结核的临床表现、X线诊断及鉴别诊断。方法回顾性分析58例下肺叶结核患者的临床及影像资料。男35例,女23例,好发于青壮年,18~35岁者占83%。结果X线检查发现病灶位于下叶背段最多;病灶性质包括渗出性病灶(45%)、增殖病灶(18%)、混合性病灶(37%);主要形态有小叶肺炎型、浸润型、团块型、肺脓肿型和支气管播散型。结论X线正侧位胸片检查对下肺叶结核诊断有较高价值,但仍有部分病例须结合其它检查手段确诊。 Objective To investigate the clinical manifestations, X-ray diagnosis and differential diagnosis of atypical lower pulmonary tuberculosis. Methods Retrospective analysis of 58 cases of pulmonary tuberculosis in patients with clinical and imaging data. 35 males and 23 females, occurs in young adults, 18 to 35 years accounted for 83%. Results X-ray examination showed that the lesion was located in the dorsal segment of the lower lobe. The nature of the lesion included exudative lesion (45%), proliferative lesion (18%) and mixed lesion (37%). Lump type, pulmonary abscess type and bronchial spread type. Conclusion X-ray examination of lateral chest radiograph has high value in the diagnosis of pulmonary tuberculosis. However, some cases should be confirmed by other examination methods.