患者女性,47岁。咳嗽、咳痰4个月,伴无痛性淋巴结肿大、皮肤搔痒3个月。3个月前患者双侧颈部及腋窝出现肿块,无痛,有皮肤搔痒,2周前双侧颈部、腋窝肿块迅速增大,伴发热,咳嗽、咳痰明显。胸部CT显示右肺中叶占位,双肺多发结节及纵隔、腋窝淋巴结肿大,考虑中央型肺癌,淋巴结转移。支气管镜检查:右肺中叶及左肺上叶支气管开口处各见一结节样肿物,完全堵塞支气管管腔,组织松软,触之 Patient female, 47 years old. Cough, expectoration for 4 months, with painless lymphadenopathy, itchy skin 3 months. 3 months ago, patients with bilateral neck and axillary mass, painless, itchy skin, bilateral neck 2 weeks ago, the rapid increase in axillary mass, with fever, cough, sputum obvious. Chest CT showed the middle of the right lung space occupying multiple lung nodules and mediastinum, axillary lymph nodes, consider the central lung cancer, lymph node metastasis. Bronchoscopy: right middle lobe and left lung lobes of the bronchial see a nodular-like tumor, completely blocked the bronchial lumen, soft tissue, touch