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伪装成肺癌的隐源性机化性肺炎:一例报告并文献复习

Cryptogenic organizing pneumonia masquerading as lung carcinoma: A case report and review of the literature.

作者信息

Huo Ji-Ping, Liu Cui, Jin Bei-Bei, Duan Feng-Xia, Mei Sheng-Hui, Li Xin-Gang, Zhao Zhi-Gang

机构信息

Department of Pharmacy, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing 100050, P.R. China.

Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China.

出版信息

Exp Ther Med. 2018 Jan;15(1):39-46. doi: 10.3892/etm.2017.5393. Epub 2017 Oct 30.

Abstract

Cryptogenic organizing pneumonia (COP) is a rare pulmonary disorder of unknown etiology. COP with hemoptysis as the primary presenting symptom has rarely been reported. The present study reported a case of COP that resembled lung carcinoma with hemoptysis as the only clinical symptom. The patient recovered well following thoracoscope surgery. A literature review of 119 COP cases between 1995 and 2015 was presented. Cough, fever and dyspnea were the most common clinical manifestations. The most common imaging manifestations were multiple or single consolidation, lung nodules, migratory sign, reversed halo sign, and multiple ground-glass opacity. A total of 3 cases exhibited COP accompanied by lung cancer. Glucocorticoids were effective for the majority of cases and invasive surgeries were implemented in most cases. The majority of cases recovered or relieved, and the prognosis of COP was relatively good. COP was easily confused with lung tumor and it is necessary to make differential diagnosis between COP and lung cancer. Invasive surgery should be avoided when possible to avoid or reduce patient trauma.

摘要

隐源性机化性肺炎(COP)是一种病因不明的罕见肺部疾病。以咯血为主要表现症状的COP鲜有报道。本研究报告了一例以咯血为唯一临床症状、酷似肺癌的COP病例。该患者在胸腔镜手术后恢复良好。本文对1995年至2015年间的119例COP病例进行了文献综述。咳嗽、发热和呼吸困难是最常见的临床表现。最常见的影像学表现为多发或单发实变、肺结节、游走征、反晕征和多发磨玻璃影。共有3例病例表现为COP合并肺癌。糖皮质激素对大多数病例有效,大多数病例实施了侵入性手术。大多数病例康复或缓解,COP的预后相对良好。COP容易与肺部肿瘤混淆,有必要对COP和肺癌进行鉴别诊断。应尽可能避免侵入性手术,以避免或减少患者创伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd97/5769272/0e6be76cb8a1/etm-15-01-0039-g00.jpg

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