临床误诊误治2025，Vol.38Issue(4)：11-16,6.DOI:10.3969/j.issn.1002-3429.2025.04.003
以胸闷和气短为主要症状的肺结节病误诊分析及文献学习
Misdiagnosis and Literature Review of Pulmonary Sarcoidosis with Chest Tightness and Shortness of Breath as Main Symptoms
李梦聪 1王娜 1王广东 1刘婷婷 1纪文文 1石志红1
作者信息
- 1. 710061 西安,西安交通大学第一附属医院呼吸与危重症医学科
- 折叠
摘要
Abstract
Objective To explore the causes of misdiagnosis of pulmonary sarcoidosis(PS)as pulmonary tuberculo-sis and preventive measures.Methods The clinical treatment process of a PS patient who was misdiagnosed with pulmonary tuberculosis in May 2023 was analyzed,and the causes of misdiagnosis and preventive measures based on relevant literature were analyzed.Results The main symptoms of the patient were intermittent chest tightness and shortness of breath.Chest CT indicated the possibility of bilateral secondary pulmonary tuberculosis,and the patient was diagnosed with pulmonary tubercu-losis.At 10 months after anti-tuberculosis treatment with Isoniazid+Rifampicin+Ethambutol,the symptoms were not alle-viated significantly.Laboratory examination,chest CT and tracheoscopy were performed,and tissues and cells were taken for pathological examination,which revealed granulomatous inflammation of bronchial mucosa.Finally,after multidisciplinary di-agnosis and treatment,PS was considered for diagnosis,and the duration of misdiagnosis was 11 months.After diagnosis,oral Prednisone tablet(25 mg,1/d)was given,and gradually reduced regularly for 10 months.The patient visited the doctor reg-ularly,and reported that the symptoms were relieved.Reexamination of chest CT showed mediastinal enlargement,gradual re-duction of lymph nodes,multiple lung cord shadows,gradual improvement of pleural effusion,and improvement in pulmonary function.The drug has been discontinued for 2 months and is under follow-up.Conclusion Most of the symptoms of PS pa-tients are non-specific and belong to exclusive diagnostic diseases.Detailed history collection,physical examination and auxil-iary examination should be actively performed for diagnosis,and multidisciplinary diagnosis and treatment should be carried out when necessary to reduce misdiagnosis.关键词
肺结节病/误诊/肺结核病/肉芽肿/支气管镜/多学科诊疗/糖皮质激素/诊断Key words
Pulmonary sarcoidosis/Misdiagnosis/Pulmonary tuberculosis/Granuloma/Bronchoscopy/Multidisci-plinary team diagnosis/Glucocorticoids/Diagnosis分类
医药卫生引用本文复制引用
李梦聪,王娜,王广东,刘婷婷,纪文文,石志红..以胸闷和气短为主要症状的肺结节病误诊分析及文献学习[J].临床误诊误治,2025,38(4):11-16,6.
