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[肺结核与肺癌的鉴别诊断。65例经纤维支气管镜诊断的肺结核病例分析]

[Differential diagnosis between tuberculosis and cancer of lung. Analysis of 65 tuberculosis cases diagnosed by fiber-bronchoscopy].

作者信息

He L X

机构信息

Zhongshan Hospital, Shanghai Medical University.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 1991 Apr;14(2):69-70, 125.

PMID:1879017
Abstract

A series of 65 broncho-pulmonary TB simulating lung cancer with negative AFB in sputum were diagnosed by fiber-bronchoscopy. 60% of the cases were at the age of forty and over. According to the radiographic features, they could be divided into 3 varieties: (1) 31 cases showed mass or nodal shadow. 7 of the 11 cases with cavities mimicked cancer origin in appearance. (2) 30 cases showed atelectasis and segmental shadows with 16 cases in nonpredisposing location of TB. (3) 4 cases with diffuse interstitial and micronodular shadows were different from miliary TB. Of a total of 65 cases, 7 accompanied with hilar/mediastinum adenopathy. Using fiber-bronchoscopy, bronchial lesions were found in 24 cases (36.9%). TB diagnosed by pathological and bacteriological examination were 89.2% and 32.2% respectively. TB combined with squamous cell cancer of the lung was found in one patient. These data indicated that TBB and TBLB provided an effective method in the differential diagnosis of TB and cancer of lung.

摘要

通过纤维支气管镜检查诊断出一系列65例痰涂片抗酸杆菌阴性、疑似肺癌的支气管 - 肺结核病例。60%的病例年龄在40岁及以上。根据影像学特征,它们可分为3种类型:(1)31例表现为肿块或结节阴影。11例有空洞的病例中,有7例在外观上酷似癌源。(2)30例表现为肺不张和肺段阴影,其中16例位于非结核好发部位。(3)4例有弥漫性间质和微小结节阴影,与粟粒性结核不同。65例病例中,7例伴有肺门/纵隔淋巴结肿大。使用纤维支气管镜检查,在24例(36.9%)中发现了支气管病变。经病理和细菌学检查确诊为结核的分别为89.2%和32.2%。1例患者发现结核合并肺鳞状细胞癌。这些数据表明,经支气管活检和经支气管肺活检为肺结核和肺癌的鉴别诊断提供了一种有效的方法。

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