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随着CT、核磁共振等高分辨率影像学技术的相继问世及应用,肺癌的早期检出率显著提高,但对于一些不典型肺癌误诊仍较多,本文报告4例如下: 例1,男,72岁,工人。持续低烧、胸闷、进行性消瘦8个月,先后三次在本院住院,均诊断为细菌性肺脓疡,脓胸,经抗感染治疗,闭式引流,效果不佳。入院后胸片提示右胸从第四前肋以下均呈致密阴影,纵隔左移。血常规,Hb80g/L, WBC11.6×10~9/L,N84％,ESR48mm/h。胸穿抽出咖啡色脓液400ml,胸水送验,脓细胞+++,红细胞++。痰脱落细胞检查发现鳞癌细胞,支气管镜检证实为鳞瘤。例2,男,42岁,干部。持续低烧、咳嗽、痰中带血月余。胸片提示左肺门增宽,两下肺可见斑
With the advent of CT and MRI and other high-resolution imaging technologies, the early detection rate of lung cancer has been significantly increased, but misdiagnosis of some atypical lung cancer is still more, this report 4 cases as follows: Example 1, male, 72 years old, worker. Continuous low fever, chest tightness, progressive weight loss for 8 months, has three hospitalizations in our hospital, were diagnosed as bacterial lung abscess, empyema, anti-infective treatment, closed drainage, ineffective. Chest radiography after admission prompted the right chest from the fourth before the rib were dense shadow, left mediastinum. Blood, Hb80g / L, WBC11.6 × 10 ~ 9 / L, N84%, ESR48mm / h. Breast wear out of the coffee pus 400ml, pleural effusion delivery, pus +++, red blood cells ++. Sputum exfoliated cells found squamous cell carcinoma, bronchoscopy confirmed as squamous cell tumor. Example 2, male, 42 years old, cadre. Continuous low-grade fever, cough, bloody sputum more than a month. Chest prompted the left hilar widened, two spots can be seen in the lungs