人们认为“肺部疾病 X 线表现看得见,但猜不着。”说明肺部疾患诊断问题错综复杂。国内有关其它肺部疾患误诊为结核的报道甚多,医务工作者也比较注意这方面的教训。相反,把肺结核误诊为其它肺部疾患的教训虽也不少,但报道不多,尤其是不典型的浸润性肺结核和胸膜炎、干酪性肺炎、病灶周围炎等易误诊为大叶性肺炎。本文就误诊两周以上、动态观察至少一年的86例,作为讨论对象,从中吸取教训。确诊依据86例中,痰中找到结核杆菌者36例,占41.86%。1例术后病检证实,占1.16%。17例胸水检查确诊为结核性胸膜炎,经抗痨治愈,占19.77%。原发结核18例,动态观察中均出现典型的 X 线表现,最后留下原发钙化群,占20.93%。14例在长期观察中, People think that “lung disease X-ray performance is visible, but guess not.” Explain the complex diagnosis of lung disease problems. There are many reports of misdiagnosis of tuberculosis in other lung diseases in China. Medical workers also pay more attention to this lesson. On the contrary, there are a lot of lessons learned from misdiagnosing tuberculosis as other lung diseases. However, few reports have been reported. In particular, atypical infiltrative pulmonary tuberculosis and pleurisy, caseic pneumonia and perihepatic inflammation are easily misdiagnosed as lobar pneumonia. This article on misdiagnosis of more than two weeks, dynamic observation of at least one year of 86 cases, as the object of discussion, to learn from. Diagnosis was based on 86 cases, sputum found in 36 cases of Mycobacterium tuberculosis, accounting for 41.86%. A case confirmed postoperative examination, accounting for 1.16%. 17 cases of pleural effusion diagnosed as tuberculous pleurisy, anti-tuberculosis cure, accounting for 19.77%. Primary tuberculosis in 18 cases, the dynamic observation showed a typical X-ray findings, leaving the primary calcification group, accounting for 20.93%. 14 cases in the long-term observation,