Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Int J Tuberc Lung Dis. 2011 May;15(5):674-9. doi: 10.5588/ijtld.10.0494.
To determine how pulmonary paragonimiasis may be confused with lung cancer, we retrospectively analysed the clinical and radiological characteristics of 47 patients (27 males, median age 55 years; interquartile range 49-61) with serologically or histopathologically confirmed pulmonary paragonimiasis seen between October 2004 and December 2009.
Respiratory symptoms were present in 29 (62%) patients; the remaining 18 (38%) were asymptomatic. Chest radiography (CXR) revealed intrapulmonary parenchymal lesions (n = 35, 75%) more frequently than pleural lesions (n = 11, 23%). Of the 47 patients, 28 (60%) were referred for suspected lung cancer. The majority of these patients had no symptoms, and 22 (79%) patients with suspected lung cancer had nodular or mass lesions on CXR. As a result, additional diagnostic procedures were performed to make an accurate diagnosis in these patients, including bronchoscopy in 20, transthoracic lung biopsy in 11 and fluorodeoxyglucose positron emission tomography in seven. Surgical lung resection was performed unnecessarily in six patients.
Pulmonary paragonimiasis presenting with nodular or mass lesions on CXR is common. Clinicians should therefore include pulmonary paragonimiasis in the differential diagnosis of asymptomatic nodular lesions in the lung in patients who have lived in or travelled to paragonimiasis-endemic areas.
为了确定肺并殖吸虫病可能与肺癌混淆的情况，我们回顾性分析了 2004 年 10 月至 2009 年 12 月期间经血清学或组织病理学证实的 47 例肺并殖吸虫病患者（27 例男性，中位年龄 55 岁；四分位间距 49-61）的临床和影像学特征。
29 例（62%）患者有呼吸道症状；其余 18 例（38%）无症状。胸部 X 线摄影（CXR）显示肺实质内病变（n = 35，75%）比胸膜病变（n = 11，23%）更常见。在 47 例患者中，28 例（60%）因疑似肺癌转诊。这些患者大多无症状，22 例（79%）疑似肺癌患者的 CXR 上有结节或肿块病变。因此，对这些患者进行了额外的诊断程序以做出准确诊断，包括支气管镜检查 20 例，经胸肺活检 11 例和氟脱氧葡萄糖正电子发射断层扫描 7 例。6 例患者不必要地进行了手术肺切除。
CXR 上表现为结节或肿块病变的肺并殖吸虫病很常见。因此，对于居住或旅行到并殖吸虫病流行地区的无症状肺部结节患者，临床医生应将肺并殖吸虫病纳入鉴别诊断。
