Doshi Viral K, Kulkarni Shreedhar R, Kham Nang M, Kapitan Kent S
Division of Pulmonary and Critical Care Medicine
Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois.
Respir Care. 2015 Mar;60(3):e56-8. doi: 10.4187/respcare.03549. Epub 2014 Oct 21.
Coexistence of Mycobacterium xenopi with lung cancer has been reported. However, lung cancer originating within a pre-existing cavity caused by M. xenopi has not. A 55-y-old woman with a history of smoking presented with complaints of chronic dry cough, night sweats, and weight loss for several months. Computed tomography (CT) scanning revealed a 3.5-cm irregular thick-walled cavity in the right lung apex. Cultures obtained from a CT-guided biopsy grew M. xenopi. The patient received standard treatment, and her clinical symptoms improved, and the radiographic lesion stabilized. However, 2 y later, a repeat chest x-ray showed the original right upper lobe cavity with an interval development of a mass adjoining the cavity. A CT-guided needle biopsy of the new mass demonstrated squamous cell carcinoma. Whenever there is a change in the radiological appearance of a cavity, a repeat biopsy should be performed to exclude lung cancer.
曾有报道称偶发分枝杆菌与肺癌并存。然而，由偶发分枝杆菌引起的既有空洞内发生肺癌的情况尚未见报道。一名有吸烟史的55岁女性，主诉慢性干咳、盗汗及体重减轻数月。计算机断层扫描（CT）显示右肺尖有一个3.5厘米的不规则厚壁空洞。CT引导下活检所获培养物培养出偶发分枝杆菌。患者接受了标准治疗，临床症状改善，影像学病变稳定。然而，2年后，重复胸部X线检查显示原右上叶空洞，空洞旁有一肿物逐渐增大。对新肿物进行CT引导下针吸活检显示为鳞状细胞癌。每当空洞的影像学表现发生变化时，应再次活检以排除肺癌。
