临床误诊误治2017，Vol.30Issue(8)：1-4,4.DOI:10.3969/j.issn.1002-3429.2017.08.001
支气管结核误诊为肺癌七例临床分析
Clinical Analysis of 7 Patients with Bronchial Tuberculosis Misdiagnosed as Having Lung Cancer
摘要
Abstract
Objective To investigate causes and preventative measures of bronchial tuberculosis misdiagnosed as lung cancer.Methods Clinical data of 7 patients misdiagnosed as having bronchial lung cancer, among whom 25 patients had bronchial tuberculosis admitted during march 2013 and December 2015, was retrospectively analyzed.Results The misdiagnosis rate was 28.00%.There were 6 patients with cough, 5 with expectoration, 4 with blood in phlegm or a little of haemoptysis, 4 with sustained fever for longer than 2 weeks, 3 with dyspnea, 2 with chest pain, 3 with fatigue and night sweats and 2 patients with poor appetite and weight loss.In primary diagnosis, 6 patients were misdiagnosed as having bronchial lung cancer, and 1 was misdiagnosed as having bronchopneumonia combined with pulmonary tuberculosis.Misdiagnosed time was 1-12 months.Patients'' conditions did not obviously improve after corresponding treatment for misdiagnosed diseases.Bronchial tuberculosis was confirmed after bronchovideoscopy, repeated bronchial mucosal histopathologic examination under fiberoptic bronchoscopy and brushing smear for finding acid fast bacilli.The 7 patients received treatments such as anti-tuberculosis routine therapy, which included 1 patient with surgical resection and 1 with stent placement.Symptoms of the 7 patients were relieved after treatment for 1 month, and rechecking chest X-ray or CT showed that lesions were absorbed compared with those before treatment.The patients were discharged after hospitalization for 1-5 months, and anti-tuberculosis therapy was continued after discharging.Conclusion Bronchial tuberculosis is easily misdiagnosed as lung cancer because of atypically clinical manifestations, and similar manifestations to lung cancer by X-ray and CT examinations.Patients with similar manifestations to the patients in this study should give bronchovideoscopy, repeated bronchial mucosal histopathologic examination under fiberoptic bronchoscopy and brushing smear for finding acid fast bacilli in time in order to confirm the diagnosis as early as possible.关键词
结核/支气管/误诊/肺肿瘤Key words
Tuberculosis/Bronchi/Misdiagnosis/Lung neoplasms分类
医药卫生引用本文复制引用
陈凤,胥进..支气管结核误诊为肺癌七例临床分析[J].临床误诊误治,2017,30(8):1-4,4.基金项目
四川省卫计委科研课题资助项目(120148) （120148）
