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[肺包虫囊肿破裂的误诊:38例报告]

[Misdiagnosis of pulmonary hydatid cyst rupture: report of 38 cases].

作者信息

Zhang Qin, Huang Tian-ming, Li Bao-zhou, Li Zhong-liang, Liao Kai-xing

机构信息

Department of Respiratory Medicine, The General Hospital of Coal Industry Limited Corporation of Jingyuan, Gansu Province, Jingyuan 730913, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2003 Aug;26(8):474-6.

Abstract

OBJECTIVE

To improve the clinical recognition of pulmonary hydatid cyst rupture.

METHODS

Retrospective analysis of the misdiagnosis of 38 cases of hydatid cyst rupture.

RESULTS

The diagnosis of hydatid cyst rupture was confirmed by surgery and pathological study. The disease was misdiagnosed as pneumonia in 11 cases, lung abscess in 4, tuberculosis in 13, tumor in 6, pleuritis in 2, and pneumothorax in 2 cases. The clinical manifestations included sudden onset cough, watery sputum, and fever. Casoni test was positive in all the cases. Chest X-ray showed right lung cysts in 26 cases, left lung cysts in 12 cases. Large irregular opacities were found in 18 cases, round lesions in 8, new moon sign on top of the cysts in 4, floating lotus sign in 4, pneumothorax in 2, and pleural effusion in 2 cases. After combination therapy with anti-infection, support and surgery by which hydatid were excised in 28 cases and lobectomy in 9 cases, all the 38 cases were cured.

CONCLUSION

Hydatid cyst rupture can be misdiagnosed as other lung diseases, most commonly pneumonia and tuberculosis.

摘要

目的

提高对肺包虫囊肿破裂的临床认识。

方法

回顾性分析38例包虫囊肿破裂的误诊情况。

结果

经手术及病理检查确诊为包虫囊肿破裂。该疾病误诊为肺炎11例、肺脓肿4例、肺结核13例、肿瘤6例、胸膜炎2例、气胸2例。临床表现为突发咳嗽、水样痰及发热。所有病例卡索尼试验均为阳性。胸部X线显示右肺囊肿26例,左肺囊肿12例。发现大片不规则阴影18例、圆形病灶8例、囊肿上方新月征4例、水上浮莲征4例、气胸2例、胸腔积液2例。经抗感染、支持治疗及手术治疗(28例行包虫切除术,9例行肺叶切除术)后,38例均治愈。

结论

肺包虫囊肿破裂可误诊为其他肺部疾病,最常见的是肺炎和肺结核。

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