临床误诊误治2013，Vol.26Issue(6)：18-20,3.DOI:10.3969/j.issn.1002-3429.2013.06.009
坏死性肉芽肿性血管炎误诊为肺癌原因讨论
Cause Analysis and Literature Review: Necrotic Granulomatous Angiitis Misdiagnosed as Lung Cancer
梅周芳 1钱凌 1李小静 2揭志军1
作者信息
- 1. 200240上海,复旦大学附属上海市第五人民医院呼吸内科
- 2. 200240上海,复旦大学附属上海市第五人民医院病理科
- 折叠
摘要
Abstract
Objective To analyze clinical features and diagnostic methods of necrotic granulomatous angiitis so as to reduce misdiagnosis rate.Methods Clinical data of a patient with necrotic granulomatous angiitis in our hospital were retrospectively analyzed,and related literature were also reviewed.Results The patient was admitted for recurrent fever and blood sputun for a week,and was misdiagnosed as having lung cancer by thorax CT examination in another hospital.In our department,enhancement CT showed multiple masses in both lungs with vacuolar signs in some masses; but no neoplasm was revealed by fiberoptic bronchoscopy.Pulmonary puncture biopsy showed active chronic inflammation with massive necrosis and hemorrhage.Results of perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) and proteinase 3-specific anti-neutrophil cytoplasmic antibodies (PR3-ANCA)tests were positive.Necrotic granulomatous angiitis was confirmed,and high-dose glucocorticoids combined with cyclophosphamide (CTX) impingement treatment was given.The patient's symptom significantly improved,and most lesions were absorbed.The patient's pathogenetic condition was stable during glucocorticoids sequential therapy as shown by 6 months of follow-up.Conclusion Necrotic granulomatous angiitis is rare in clinical practice,so clinicians should pay more attention.The pathological and ANCA tests are very important in final diagnosis.关键词
坏死性肉芽肿性血管炎/误诊/肺肿瘤Key words
Necrotic granulomatous angiitis/ Misdiagnosis/ Lung cancer）分类
医药卫生引用本文复制引用
梅周芳,钱凌,李小静,揭志军..坏死性肉芽肿性血管炎误诊为肺癌原因讨论[J].临床误诊误治,2013,26(6):18-20,3.
