【摘要】 目的探讨腺泡状软组织肉瘤(alveolar soft part sarcoma,ASPS)临床特点、误诊原因及防范措施。方法回顾分析我院近期收治的1例误诊为肺结核的ASPS肺转移的临床资料并复习相关文献。结果本例因咳嗽、咳痰6个月,进行性气短3个月入院。CT检查示双肺弥散实性结节影,红细胞沉降率35 mm/h,诊断为双肺继发性肺结核并给予抗结核治疗。后行CT引导下经皮肺穿刺活检,证实为ASPS肺转移。予吡柔比星加异环磷酰胺化学治疗,目前病情稳定。结论 ASPS临床罕见,以肺转移为首发表现时易误诊。临床上对于青少年,特别是女性,肺部表现为富血供转移瘤改变,在除外其他肿瘤性病变时,应考虑到ASPS,积极寻找原发病灶并行穿刺活检以尽早明确诊断。更多还原

【Abstract】 Objective To analyze the clinical characteristics and misdiagnosis causes of alveolar soft part sarcoma( ASPS),and investigate the prevention measures of misdiagnosis. Methods The clinical data of a patient with pulmonary metastasis of ASPS misdiagnosed with tuberculosis was analyzed retrospectively,and related literature was reviewed. Results The patient was admitted for cough and expectoration for 6 months and progressive shortness of breath for 3 months. CT image showed diffuse pulmonary solid nodules. Erythrocyte sedimentation rate was 35 mm / h. Then the patient was diagnosed as having bilateral secondary pulmonary tuberculosis and given with anti-tuberculous therapy. At last,the patient accepted CTguided percutaneous lung biopsy. The pathologic result was pulmonary metastasis of ASPS. After treatment with pirarubicin and ifosfamide,the condition of the patient was stable. Conclusion ASPS is rare in clinic,and lung metastasis could be the first imaging finding of ASPS that may be misdiagnosed easily. After exclusion of tumors,those cases whose pulmonary manifestations were hypervascular metastasis changes should be suspected of ASPS,especially for adolescents and female.更多还原