摘要
Abstract
Objective To discuss clinical characteristics, causes and preventive measures of central bronchogenic carcinoma combined with bronchial tuberculosis. Methods Clinical data of 1 missed diagnosis patient with central broncho-genic carcinoma combined with bronchial tuberculosis was retrospectively analyzed. Results The patient was admitted cough, expectoration, dyspnea and shortness of breath for 10 years, bloody sputum for 5 years and aggravation for 1 year. The patient was diagnosed as having pulmonary tuberculosis in other hospital, and received anti tuberculosis treatment for 6 months, but the symptoms were not significantly improved, and then the patient visited Hebei Provincial Chest Hospital. After admission, the patient received examinations such as several times of sputum pathology, tumor marker, sputum acid fast staining, tuber-culosis infectious T cells detection, purified protein derivative of tuberculin ( PPD) test, chest CT and bronchoscopy, and bronchial tuberculosis was diagnosed. The patient was treated with anti tuberculosis treatment for 2 months, and the symptoms were significantly improved, but the rechecked chest CT showed no obvious lesion absorption. Rechecked tracheoscopy showed that decreased visible necrotic tissues in the left upper lobe and neoplasm under the sphacelus. Biopsy histopathology examina-tion showed degenerated foreign cells associated by a large number of necrotic tissues, and brushing pathological examination showed tumor cells. The patient was diagnosed as having central bronchogenic carcinoma combined with bronchial tuberculo-sis, and was transferred to oncology department for further treatment. The patient showed significant improvement in symptoms after having chemoradiotherapy and adjunctive anti-tuberculosis therapy, and the patient had a good condition and received chemotherapy regularly. Conclusion Clinicians should be more careful when are analyzing the patient's condition and ima-ging findings, improve professional skills, not to rely on medical examination results too much and broaden their diagnosed mind so as to reduce or avoid missed diagnosis of central bronchogenic carcinoma combined with bronchial tuberculosis.关键词
肺肿瘤/结核/支气管/漏诊Key words
Lung neoplasms/Tuberculosis/Bronchi/Missed diagnosis分类
医药卫生
