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一例被误诊为肺炎的肺铁末沉着症病例。

A case of pulmonary siderosis misdiagnosed as pneumonia.

作者信息

Oh Su-Jin, Hwang Ki-Eun, Jeong Eun-Taik, Kim Hak-Ryul

机构信息

Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University, School of Medicine, Iksan, Jeonbuk, South Korea.

出版信息

Respir Med Case Rep. 2018 Jun 21;25:58-60. doi: 10.1016/j.rmcr.2018.06.006. eCollection 2018.

Abstract

We report first case of pulmonary siderosis appearing as a consolidation upon radiological examination and being misdiagnosed as pneumonia. A 59-year-old man visited our hospital with a cough and sputum that had persisted for more than a month. He had undergone chest computed tomography (CT) after abnormal findings on chest X-ray at other hospitals. Based on the chest CT results, he was diagnosed with pneumonia. He was then administered antibiotics for 3 weeks, but there was no improvement. We identified the patient's occupational history first, and then performed bronchoalveolar lavage and chest CT-guided transthoracic lung biopsy. The obtained specimen showed alveolar, macrophage-containing, Prussian blue-positive iron particles. Based on the results, we diagnose/d the patient with pulmonary siderosis. We advised him to discontinue his job. He is currently undergoing observation, and has not shown any special symptoms.

摘要

我们报告首例肺铁末沉着症,其在放射学检查时表现为实变,被误诊为肺炎。一名59岁男性因咳嗽和咳痰持续一个多月前来我院就诊。他在其他医院胸部X线检查发现异常后接受了胸部计算机断层扫描(CT)。根据胸部CT结果,他被诊断为肺炎。随后他接受了3周的抗生素治疗,但病情没有改善。我们首先了解了患者的职业史,然后进行了支气管肺泡灌洗和胸部CT引导下的经胸肺活检。所获得的标本显示肺泡内有含巨噬细胞的普鲁士蓝阳性铁颗粒。根据这些结果,我们诊断该患者为肺铁末沉着症。我们建议他停止工作。他目前正在接受观察,尚未出现任何特殊症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15eb/6039750/d885085f44ce/gr1.jpg

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