Weimar B, Morr H, Müller K M
Klinik für Lungen- und Bronchialerkrankungen Waldhof Elgershausen, Greifenstein.
Dtsch Med Wochenschr. 1988 Dec 23;113(51-52):2010-2. doi: 10.1055/s-2008-1067929.
A chance finding of a sheet-like, dorsal opacification in the left lower lung field of a 77-year-old nonsmoking woman was at first misdiagnosed as tuberculosis because mycobacteria were demonstrated in bronchial secretion. Before it was shown that they were atypical mycobacteria, only facultatively pathogenic, tuberculostatic treatment was started. But both radiologically and clinically the patient's condition deteriorated, with fever and enlargement of the pulmonary lesion. The left lower lobe was resected on suspicion of a chronic pneumonia with consolidation and ultimately abscess formation. The preliminary histological diagnosis of the resected lobe was of a small-cell bronchial carcinoma, stage pT3N0Mx. Further immunohistochemical tests, however, revealed a malignant fibrous histiocytoma which is extremely rare in the lung.
一名77岁不吸烟女性左下肺野出现片状背侧混浊，这一偶然发现起初被误诊为肺结核，因为在支气管分泌物中发现了分枝杆菌。在证实它们是非典型分枝杆菌（仅兼性致病）之前，就开始了抗结核治疗。但无论从放射学还是临床角度看，患者病情都恶化了，出现发热和肺部病变增大。因怀疑是慢性肺炎伴实变并最终形成脓肿，切除了左下叶。切除肺叶的初步组织学诊断为小细胞支气管癌，pT3N0Mx期。然而，进一步的免疫组化检测显示是恶性纤维组织细胞瘤，这在肺部极为罕见。
