目的通过对同时双原发肺癌典型病例的分析,提高医务人员对该病的临床认知。方法分析2012年我科收治的1例经电子支气管镜确诊的同时双原发肺癌(鳞状细胞癌+小细胞癌)的临床表现、影像学特点及支气管镜表现,并结合病例进行相关文献复习。以“双原发、肺癌、小细胞癌、鳞癌”为检索词,通过万方医学数据库和中国知识资源总库对中文文献进行检索;以“double primary,lung cancer,squamous cell carcinoma,small cell lung carcinoma”为检索词,通过Pub Med数据库进行检索。结果患者为76岁男性,因“咳嗽、胸痛、憋喘半个月余”入院,行胸部CT示右肺门团块状高密度影,并行支气管镜检查,活检组织病理学检查及免疫组织化学检查证实为右上支气管鳞状细胞癌、右中间段支气管小细胞癌,其影像学表现、支气管镜表现与病理诊断相一致。在上述数据库仅见7篇类似病例报道。7例患者均有长期吸烟史,其中男6例。4例患者主要临床症状为咳嗽、咳痰,1例患者仅表现为胸痛。7例患者胸部CT表现为肺(门)占位或伴支气管狭窄闭塞。5例经支气管镜活检病理确诊。结论双原发肺癌影像学表现及支气管镜表现有一定特征,及时经支气管镜检查及活检组织病理有助于诊断。 Objective To improve the clinical cognition of medical staff by analyzing the typical cases of double primary lung cancer at the same time. Methods We analyzed the clinical manifestations, imaging features and bronchoscopic findings of one case of double primary lung cancer (squamous cell carcinoma + small cell carcinoma) diagnosed by electronic bronchoscopy in 2012 in our department and reviewed the related literatures . The Chinese literature was searched with “double primary lung cancer, small cell lung cancer and squamous cell carcinoma” using Chinese medicine database and Chinese knowledge base. The data of “double primary, lung cancer, squamous cell carcinoma , small cell lung carcinoma ”as a search term, retrieved by the Pub Med database. Results A 76-year-old man was admitted to the hospital due to “coughing, chest pain, and wheezing for more than half a month.” Chest CT showed right hilar mass hyperplasia, parallel bronchoscopy, biopsy histopathology and immunohistochemistry Chemical examination confirmed the right upper bronchial squamous cell carcinoma, the right middle small cell lung cancer, the imaging findings, bronchoscopy and pathological diagnosis consistent. Only seven similar cases were reported in the above database. All 7 patients had long-term smoking history, including 6 males. The main clinical symptoms of 4 patients were cough and expectoration, and only 1 patient showed chest pain. Seven patients with chest CT showed lung (door) or bronchial stenosis occlusion. Five cases were diagnosed by bronchoscopy biopsy. Conclusion The imaging features of primary lung cancer and bronchoscopy have certain characteristics. The bronchoscopy and biopsy histopathology are helpful to the diagnosis.