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[胰腺腺癌的肺转移:留意第二趟列车!]

[Lung metastases of pancreatic adenocarcinoma: Watch for the second train!].

作者信息

Ropars C, Kerjouan M, Larible C, Llamas Gutierrez F, Léderlin M, De Latour B, Desrues B, Jouneau S

机构信息

Service de pneumologie, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.

Service de pneumologie, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.

出版信息

Rev Mal Respir. 2019 Jun;36(6):738-741. doi: 10.1016/j.rmr.2019.04.005. Epub 2019 Jun 21.

Abstract

Pulmonary metastases due to a pancreatic cancer are difficult to diagnose and demonstrate a wide range of radiological patterns. We report the case of a 37-year-old female patient, without past medical history, with multicystic lung disease in a context of chronic abdominal pain, fatigue and weight loss. After several months of diagnostic delay, pathological examination of surgical lung biopsies led to the diagnosis of secondary deposits of pancreatic cancer. The clinical and radiogical situation deteriorated quickly with the development of alveolar consolidation and Aspergillus superinfection was then diagnosed. This case illustrates the value of an early decision to undertake surgical lung biopsy in the work-up of multicystic lung disease when cancer is suspected. In addition, in the specific context of cancer, faced with clinical and/or radiological deterioration, it is essential to look for infection, particularly aspergillosis.

摘要

胰腺癌导致的肺转移难以诊断,且呈现出广泛的放射学表现。我们报告一例37岁女性患者,既往无病史,因慢性腹痛、乏力和体重减轻出现多囊性肺病。经过数月的诊断延误后,手术肺活检的病理检查确诊为胰腺癌继发性 deposits。随着肺泡实变的发展,临床和放射学情况迅速恶化,随后诊断出曲霉菌二重感染。该病例说明了在怀疑癌症时,早期决定对多囊性肺病进行手术肺活检在检查中的价值。此外,在癌症的特定背景下,面对临床和/或放射学恶化,寻找感染,尤其是曲霉菌病至关重要。

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