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感染还是恶性肿瘤?酷似肺炎的恶性肺肿块

Infection or Malignancy? Malignant Pulmonary Mass Mimicking Pneumonia.

作者信息

Evman Serdar, Bostanci Korkut, Yuksel Mustafa

机构信息

Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, Istanbul, Turkey.

Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey.

出版信息

Surg J (N Y). 2016 Feb 3;2(1):e11-e13. doi: 10.1055/s-0036-1572359. eCollection 2016 Mar.

Abstract

A 36-year-old woman, unresponsive to pneumonia antibiotherapy followed by antituberculosis treatment, was referred to our clinic. Thorax computed tomography (CT) and positron emission tomography CT showed cystic mass and mediastinal lymph node with suspicion of malignancy. Fine needle aspiration biopsy and mediastinoscopy showed no malignancy, so the patient underwent an exploratory thoracotomy. A frozen section of wedge-resected mass was reported as adenocarcinoma, leading to right lower lobectomy with mediastinal lymph node dissection. Besides cutting-edge diagnostic techniques, exploratory thoracotomy for cavitary lung lesions can still be necessary, as the last-line choice. The probability of malignancy must always be considered, despite a patient's age or symptoms.

摘要

一名36岁女性,在接受肺炎抗菌治疗后又接受抗结核治疗均无反应,被转诊至我院。胸部计算机断层扫描(CT)和正电子发射断层扫描CT显示有囊性肿块和纵隔淋巴结,怀疑为恶性。细针穿刺活检和纵隔镜检查未发现恶性肿瘤,因此该患者接受了剖胸探查术。楔形切除肿块的冰冻切片报告为腺癌,遂行右下肺叶切除术并清扫纵隔淋巴结。除了先进的诊断技术外,对于空洞性肺病变,剖胸探查术作为最后一线选择仍可能是必要的。无论患者年龄或症状如何,都必须始终考虑恶性肿瘤的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3fa/5553461/507aa24c964d/10-1055-s-0036-1572359-i1500036cr-1.jpg

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