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[1例抗结核治疗期间出现新发肺部浸润的胸膜结核瘤病例]

[A case of pleural tuberculoma with new pulmonary infiltration during anti-tuberculosis therapy].

作者信息

Haranaga Shusaku, Hirai Jun, Higa Futoshi, Miyagi Kazuya, Astumi Eriko, Tateyama Masao, Fujita Jiro

机构信息

Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa 903-0215, Japan.

出版信息

Kekkaku. 2013 Nov;88(11):735-8.

Abstract

A 61-year-old woman who had received treatment for tuberculous pleurisy for 2 months visited our outpatient clinic. Chest computed tomography (CT) showed the presence of a lens-shaped pleural mass with pulmonary infiltration, despite the decreased pleural effusion. Two weeks later, chest CT showed an increase in the size of the mass and expansion of the intrapulmonary shadow. Percutaneous CT-guided lung biopsy was performed, and histopathological examination revealed granulomatous inflammation without caseous necrosis or acid-fast bacilli. Sputum culture was negative for acid-fast bacilli. Anti-tuberculosis medication was continued, and the lesions eventually resolved. These lesions were diagnosed as pleural tuberculomas, and the intrapulmonary infiltration was considered to be due to the paradoxical worsening of the patient's condition.

摘要

一名接受了2个月结核性胸膜炎治疗的61岁女性前来我们的门诊就诊。胸部计算机断层扫描(CT)显示,尽管胸腔积液减少,但仍存在一个伴有肺部浸润的透镜状胸膜肿块。两周后,胸部CT显示肿块大小增加,肺内阴影扩大。进行了CT引导下经皮肺活检,组织病理学检查显示为肉芽肿性炎症,无干酪样坏死或抗酸杆菌。痰培养抗酸杆菌阴性。继续抗结核治疗,病变最终消退。这些病变被诊断为胸膜结核瘤,肺内浸润被认为是患者病情反常恶化所致。

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