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肺癌伴霉菌感染并不少见,由于伴霉菌感染使肺癌的确诊增加困难。现就所见2例探讨其诊断问题。例1:女,42岁。因咳嗽、胸闷2月,加重伴血痰20天入院。无发热、盗汗及体重下降。查体:体温正常,左肺下部背面呼吸音略低,余未见异常。血、尿、大便三常规及血沉均正常,多次痰涂片查结核杆菌及瘤细胞均阴性。X线胸片及胸部断层片示左肺门后下一不规则肿块,左肺下叶背段支气管阻塞。经静滴青霉素等治疗,痰血不减少。纤支镜检查见左下叶支气管开口处被一菜花样肿物不全堵塞。刷检未查到瘤细胞及抗酸杆菌。直视下活检,病理切片示支气管粘膜慢性炎症及坏死组织中有大量霉菌菌丝及孢子。为排除肺癌,3天后第2次纤
Lung cancer with fungal infection is not uncommon, due to fungal infection makes the diagnosis of lung cancer increased difficult. Now we see the diagnosis of 2 cases to explore the issue. Example 1: Female, 42 years old. Due to cough, chest tightness in February, aggravated with bloody sputum admitted to hospital for 20 days. No fever, night sweats and weight loss. Physical examination: normal body temperature, left lower respiratory breath slightly lower, I no abnormalities. Blood, urine, stool and erythrocyte sedimentation rate are normal, repeatedly sputum smear check Mycobacterium tuberculosis and tumor cells were negative. X-ray and thoracic tomography showed an irregular mass after the left hilar and the left lower lobe of the bronchial obstruction. After intravenous infusion of penicillin and other treatment, sputum blood is not reduced. Bronchoscopy bronchial opening of the left lower lobe was found to be a cauliflower tumor incomplete blockage. Brush inspection did not find tumor cells and acid-fast bacilli. Biopsy under direct vision, pathology showed bronchial mucosal chronic inflammation and necrosis in a large number of mold mycelium and spores. To rule out lung cancer, 2 days after 3 days