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包虫囊肿的诊断困境:类似肿瘤的包虫囊肿

Diagnostic Dilemma in Hydatid Cysts: Tumor-Mimicking Hydatid Cysts.

作者信息

Çobanoğlu Ufuk, Aşker Selvi, Mergan Duygu, Sayır Fuat, Bilici Salim, Melek Mehmet

机构信息

Department of Chest Surgery, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey.

Department of Chest Diseases, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey.

出版信息

Turk Thorac J. 2015 Oct;16(4):180-184. doi: 10.5152/ttd.2015.4606. Epub 2015 Oct 1.

Abstract

OBJECTIVES

Hydatid cysts are sometimes confused with different pathologies, and problems arise in their diagnosis and treatment. In this study, cases that are followed up with a diagnosis of lung malignancy and that are detected to have hydatid cysts were retrospectively examined.

MATERIAL AND METHODS

Seven patients with hydatid cysts whose clinical and radiological features were consistent with lung malignancy were retrospectively examined between 2010 and 2014 regarding sex, age, symptoms, diagnostic methods, surgical procedures performed, and postoperative complications. In the diagnosis of the patients, radiological diagnostic methods such as chest radiography, thoracic computed tomography (TCT), and positron emission tomography+computed tomography (PET-CT) as well as invasive diagnostic methods such as bronchoscopy, fine-needle aspiration biopsy, thoracentesis, and video-assisted thoracoscopic surgery were used.

RESULTS

The average diameter of the lesions was determined as 4.14±1.57 cm in TCT. Maximum standardized uptake value (SUV max) was measured as 8.77±3.41 (5.4-15.1) in the PET-CT analysis. Bronchoscopy, fine-needle aspiration biopsy, and thoracentesis yielded no results. Definitive diagnosis was established by performing thoracotomy and video-assisted thoracoscopic surgery.

CONCLUSION

Pulmonary hydatid cysts can appear as malignant diseases such as lung cancer as well as infectious pathologies such as tuberculosis or benign pathologies. Radiologically, it should be kept in mind that pulmonary hydatid cysts can mimic many pulmonary pathologies, particularly malignancies. Necessary examinations towards its differential diagnosis must be performed in the preoperative period.

摘要

目的

包虫囊肿有时会与不同的病理情况相混淆,在其诊断和治疗方面会出现问题。在本研究中,对诊断为肺恶性肿瘤并经检测发现有包虫囊肿的病例进行了回顾性检查。

材料与方法

回顾性检查了2010年至2014年期间7例临床和放射学特征与肺恶性肿瘤相符的包虫囊肿患者的性别、年龄、症状、诊断方法、所施行的外科手术以及术后并发症。在患者诊断过程中,使用了胸部X线摄影、胸部计算机断层扫描(TCT)、正电子发射断层扫描+计算机断层扫描(PET-CT)等放射学诊断方法以及支气管镜检查、细针穿刺活检、胸腔穿刺术和电视辅助胸腔镜手术等侵入性诊断方法。

结果

TCT检查确定病变的平均直径为4.14±1.57厘米。PET-CT分析中最大标准化摄取值(SUV max)测量为8.77±3.41(5.4 - 15.1)。支气管镜检查、细针穿刺活检和胸腔穿刺术均未得出结果。通过开胸手术和电视辅助胸腔镜手术确立了明确诊断。

结论

肺包虫囊肿可表现为肺癌等恶性疾病以及肺结核等感染性病变或良性病变。在放射学上,应牢记肺包虫囊肿可模仿许多肺部病变,尤其是恶性病变。术前必须进行必要的鉴别诊断检查。

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本文引用的文献

10
Unusual imaging characteristics of complicated hydatid disease.复杂型包虫病的异常影像学特征。
Eur J Radiol. 2007 Jul;63(1):84-93. doi: 10.1016/j.ejrad.2007.01.001. Epub 2007 Feb 1.

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