摘要
目的探讨肺放线菌病临床特点及与肺癌的鉴别诊断以减少误诊。方法总结我院确诊的3例及国内1995年至今的相关文献报道,回顾性分析国内肺放线菌病的临床资料。结果 48例肺放线菌病中,主要症状有咳嗽、喀痰、咯血、胸痛和低热。CT主要表现为单侧的肺实变或肿物影,其内有空洞或含气征、低密度区,胸膜增厚或积液,环形强化等。本组以病理组织学确诊为主,其中20例(41.7%)经手术明确诊断。结论本病临床症状和影像学表现与肺癌相似,对于临床疑诊为肺癌而难以与本病鉴别时,可行肺穿刺检查明确,以避免不必要的手术。
Objective To discuss the clinical features of primary pulmonary actinomycosis and the differential diagnosis with pulmonary carcinoma to avoid misdiagnosis.Methods Three cases of primary pulmonary actinomycosis were reported and literature was searched to identify Chinese primary pulmonary actinomycosis cases from 1995 to 2009,and a retrospective analysis was made.Results Among the 48 cases collected,the main clinical symptoms included cough,sputum,hemoptysis,chest pain and low-grade fever.The common findings on CT scan included unilateral patchy air-space consolidation or masses,central low attenuation,cavitation,pleural thickening or effusions,ringlike enhancement.Definite diagnosis was mainly confirmed by histopathological findings.20 patients（41.7%）in all were definitively diagnosed via surgery.Conclusion As the clinical symptoms and radiologic findings of primary pulmonary actinomycosis often simulate pulmonary carcinoma,it is commonly misdiagnosed as malignant tumor.When it could not be differentiated between pulmonary carcinoma and actinomycosis clinically,percutaneous fine-needle aspiration could be performed to make a definite diagnosis and avoid unnecessary surgery.
出处
《临床肺科杂志》
2011年第2期220-222,共3页
Journal of Clinical Pulmonary Medicine
关键词
肺放线菌病
肺癌
手术
pulmonary actinomycosis
pulmonary carcinoma
surgery
