２４例肺癌误诊分析山西省肿瘤医院放射科（０３００１３）翟守仁，阎淑琳山西省肿瘤医院同位素室郭变英胸部Ｘ线检查发现肺内孤立球形病变不难，尤其肺癌，较细胞学阳性率高［１］，为周围型肺癌诊断的重要手段之一。但肺内孤立球形病变病种繁多［２］，民同病异影及异病同影者不少，病变发展阶段不问，Ｘ线表现又多样，诸多ｘ线征象并非特异，又缺乏典型临床症状，加之分析影象时的片面性，故极易误诊。临床资料２４例中男１４例，女１０例；年龄最小１４岁，２０～４０岁２１例，４０岁以上仅２例，最大５９岁。Ｘ线诊断为肺癌，病理证实为结核的１５例、炎性包块５例，其它肺部良性肿瘤４例。１５例结核中位于肺癌好发部位者有７例。临床症状不同程度咳嗽的１７例，偶有痰血的３例，多无明显结核中毒症状。ｘ线所见以肺内各叶外围２～３ｃｍ病变为主者２２例，边缘大部较光整、无明显分叶，病灶密度多不均匀，肺门增大伴肺不张的仅２例。误诊分析本组将２４例良性病变，尤其是将１５例肺结核误诊为肺癌的原因主要是没有全面综合分析、顾此失彼。从放射科来讲，具体主要有以下几方面的原因。一、由于专业习性，对肿瘤警惕性较高，过分地强调了在院外长期治疗疗效不著或无效这一条。按常理，肺部结核 24 cases of misdiagnosis of lung cancer Shanxi Cancer Hospital Radiology (030013) Zhai Shouren, Yan Shulin Cancer Hospital of Shanxi Province Guo isotope chest X-ray examination of isolated lung lesions is not difficult to find the lungs, lung cancer in particular, the higher the positive rate of cytology [1] For the diagnosis of peripheral lung cancer one of the important ways. However, a wide range of isolated orbital lesions in the lungs [2], the same disease and different diseases with the shadow of many, the stage of disease does not ask, X-ray performance and diverse, many x-ray signs are not specific, but also the lack of a typical clinical Symptoms, combined with one-sided analysis of the image, it is easy to misdiagnosis. Clinical data of 24 cases, 14 males and 10 females; the youngest 14 years old, 21 cases of 20 to 40 years old, only 2 cases over the age of 40, maximum 59 years old. X-ray diagnosis of lung cancer, pathological confirmed tuberculosis in 15 cases, 5 cases of inflammatory mass in 4 cases of other benign lung tumors. Among the 15 cases of tuberculosis, 7 cases were found in the predilection sites of lung cancer. Clinical symptoms of different degrees of cough in 17 cases, occasional sputum in 3 cases, no obvious symptoms of tuberculosis. X-ray findings in the lungs around the leaves of 2 ~ 3cm lesions were mainly 22 cases, most of the edge of the more polished, no obvious lobulation, lesions were more heterogeneous, enlarged hilar with atelectasis in only 2 cases. Misdiagnosis Analysis The group of 24 patients with benign lesions, especially the misdiagnosis of 15 cases of pulmonary tuberculosis as lung cancer is mainly due to the lack of a comprehensive and comprehensive analysis. From the radiology is concerned, the specific main reasons for the following aspects. First, due to professional habits, higher vigilance on the tumor, over-emphasize the long-term treatment in the hospital curative effect invalid or invalid this one. Common sense, pulmonary tuberculosis