Deng Peng-bo, Luo Yang-yang, Hu Cheng-ping, Zhou Li-hua
Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2011 Sep;34(9):663-5.
To further understand the clinical features and the causes of misdiagnosis of pancoast cancer.
The data of 26 cases of pancoast cancer from 1999 - 2006 were collected for a retrospective review. The clinical and imaging features, and the causes underlying misdiagnosis were analyzed.
There were 24 males and 2 females (mean age 59 ± 6, range 44 - 70 years). The earliest clinical features of pancoast cancer included painful shoulder and back in 25 cases, upper extremity pain, palsy and numbness in 18 cases. Early respiratory symptoms such as cough and sputum were recorded in 5 cases, Horner syndrome in 2 cases, and hoarseness in 1 case. Misdiagnosis was made in 19 of the 26 cases: 13 as periarthritis humeroscapularis, 3 as cervical osteoarthritis and another 3 as pulmonary tuberculosis. CT scanning showed soft tissue masses at the apical segments of the lungs in all the cases (26/26). Three cases were misdiagnosed as "pulmonary tuberculosis" according to the images of X-ray, and another 3 went unnoticed.
Painful shoulder and back were the most common symptoms of pancoast cancer. pancoast cancer was often diagnosed at an advanced stage, and misdiagnosis was common. Thorax CT was the most valuable method for the detection of Pancoast cancer.
进一步了解肺上沟癌的临床特征及误诊原因。
收集1999年至2006年26例肺上沟癌患者的资料进行回顾性分析。对其临床及影像学特征、误诊原因进行分析。
26例患者中男性24例，女性2例（平均年龄59±6岁，范围44 - 70岁）。肺上沟癌最早出现的临床症状中，25例有肩背部疼痛，18例有上肢疼痛、麻痹及麻木。5例有咳嗽、咳痰等早期呼吸道症状，2例有霍纳综合征，1例有声音嘶哑。26例中有19例误诊：13例误诊为肩周炎，3例误诊为颈椎骨关节炎，另3例误诊为肺结核。CT扫描显示所有病例（26/26）肺尖段均有软组织肿块。3例根据X线影像被误诊为“肺结核”，另3例未被发现。
肩背部疼痛是肺上沟癌最常见的症状。肺上沟癌常被诊断为晚期，误诊常见。胸部CT是检测肺上沟癌最有价值的方法。
