【摘要】 目的探讨某些肺部慢性炎症病变酷似肺癌的原因及提高肺癌鉴别诊断的水平。方法对1999年6月￣2004年6月住院的89例酷似肺癌的肺部慢性炎症病变患者的临床病理和影像学资料进行回顾性分析。结果均经手术病理组织学确诊。肺结核39例,肺炎性假瘤24例,慢性化脓性炎症12例,其中肺脓肿2例,肺曲菌病5例,肺结核瘤4例,肺门淋巴结结核1例,肺炎性息肉1例。肺炎后改变1例,肺新型隐球菌病1例,肺放线菌病1例。年龄>40岁者65例。咳嗽咳痰62例(69.7%),咯血41例(46.1%),胸痛39例(43.8%),消瘦乏力55例(61.8%),吸烟指数>400年支72例(80.9%)。肺上叶32例(35.9%),肺中叶4例(4.5%),肺下叶53例(59.6%)。直径>2cm者65例,<2cm者24例。分叶征42例,毛刺征28例,尾征17例,切迹征14例,厚壁偏心空洞2例。结论某些肺部慢性炎症病变临床症状缺乏自身特异性,而影像学表现与肺癌存在异病同影的现象,极易误诊。可试行相应特异性抗炎治疗,必要时仍需手术探查以明确诊断。更多还原

【Abstract】 [Objective] To explore causes of pulmonary chronic inflammatory diseases mimicking lung cancer. [Methods] The clinical features , radiographic and pathological findings of 89 patients with variable pulmonary chronic inflammatory diseases mimicking lung cancer were analyzed retrospectively from June 1999 to June 2004. [Results] All cases had the final diagnosis by surgical histopathologics. Of 89 cases, there were 39 of pulmonary tuberculosis, 24 of inflammatory pseudotumor of the lung, 12 of chronic pulmonary suppurant inflammation,5 pulmonary aspergillosis, and 4 pulmonary tuberculoma, while 1, 1, 1, 1 and 1 of inflammatory polyp, lesion of secondary pneumonia, hilus tuberculous lymphadenitis, pulmonary cryptococcosis, lung actinomycosis , was found, respectively. Of these cases, 65 cases were aged higher 40. And the manifestations of those patients were as the following: dry cough 62 (69.7%), hemoptysis 41 (46.1%), chest pain 39 (43.8%) and fatigue 55 (61.8%), the numer of cigarettes per day of 72 (80.9%) patients was above 20. In radiographic findings, lesions of 32 (35.9%) and 53 (59.6%) cases existed in the upper and lower lobes of lung, respectively, just 4 (4.5%) in the midst lobar lung. As for the longest diameter,65 cases were above 2cm. Some malignant roentgen sign could be found , including lobulation sign 42, spicular sign 28, notch sign 14, pleural indentation sign 17. [Conclusions] Patients with some pulmonary chronic inflammatory diseases have the well mimetic manifestations and the same radiographic findings of the lung cancer, which is apt to misdiagnosis. In these cases, some diagnostic therapy may be performed to get the final diagnosis and if not, surgical operation must be performed.更多还原