Takeoka Hiroaki, Koga Takeharu, Yano Hirohisa, Ikeda Jiro, Nishimura Munetsugu, Kamimura Tomoko, Aizawa Hisamichi
Division of Respirology, Neurology and Rheumatology, Department of Medicine.
Clin Med Oncol. 2008;2:113-6. Epub 2008 Apr 10.
A 74-year-old man presented with gradual wall thickening of a cystic lung lesion. Serologic tests indicated Aspergillus infection, but neither fungal organisms nor evidence of malignant disease were recovered from repeated sputum collections, a bronchoscopic lung biopsy specimen, or bronchial washings. Treatment with antifungal agents did not result in clinical improvement. Surgical resection of the lesion demonstrated both squamous cell carcinoma and aspergillosis. These distinct disorders share common radiologic manifestations that can present a diagnostic challenge, as in the present case.
一名74岁男性患者出现囊性肺病变的逐渐壁增厚。血清学检查提示曲霉菌感染,但反复痰标本、支气管镜肺活检标本或支气管灌洗均未发现真菌病原体或恶性疾病证据。抗真菌药物治疗未带来临床改善。病变的手术切除显示为鳞状细胞癌和曲霉菌病。正如本例所示,这些不同的疾病具有共同的放射学表现,可能带来诊断挑战。