Pannu Bibek S, Iyer Vivek N
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Respir Med Case Rep. 2015 Oct 27;16:157-9. doi: 10.1016/j.rmcr.2015.10.005. eCollection 2015.
Chronic cough that is dry, non-productive and without constitutional symptoms is often thought to have a non-malignant etiology such as asthma, post-nasal drip or gastroesophageal reflux disease (GERD). We present a case of a patient with a 3 year history of 'chronic cough' that was dry, non-productive cough and without any constitutional symptoms. Initial chest x-ray (CXR) done 3 years ago showed some streaky atelectasis in the right middle lobe along with some volume loss on that side. Another CXR performed one and half years later showed progression to a complete right middle lobe collapse. She ultimately presented to our facility a year later with stable CXR findings, but persistent cough. A chest CT scan was suspicious for a right lower lobe mass. A PET scan subsequently confirmed a hypermetabolic right hilar mass causing extrinsic compression of the bronchus intermedius. She ultimately required a complete right pneumonectomy with partial pericardiectomy and had complete resolution of her cough. This case highlights the fact that 'chronic cough' should always be thoroughly investigated and should remain a diagnosis of exclusion until all sinister pathologies have been ruled out.
干咳、无痰且无全身症状的慢性咳嗽通常被认为病因非恶性，如哮喘、鼻后滴漏或胃食管反流病（GERD）。我们报告一例有3年“慢性咳嗽”病史的患者，其咳嗽为干咳、无痰，且无任何全身症状。3年前进行的首次胸部X线（CXR）检查显示右中叶有一些条索状肺不张，且该侧肺容积减小。一年半后进行的另一次胸部X线检查显示进展为完全性右中叶肺不张。一年后她最终到我们医院就诊，胸部X线检查结果稳定，但咳嗽持续。胸部CT扫描怀疑右下叶有肿块。随后的PET扫描证实右肺门有高代谢肿块，导致中间支气管外部受压。她最终需要进行全右肺切除术及部分心包切除术，咳嗽完全消失。该病例强调了一个事实，即对于“慢性咳嗽”应始终进行全面检查，在排除所有严重病变之前，应一直作为排除性诊断。
