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成人患者血清血沉加快、结核抗体阳性合并胸部CT扫描左肺实变,初诊为肺结核,经支气管镜检查证实为左主支气管异物吸入:病例报告及文献复习

Increased Serum Sedimentation and Positive Tuberculosis Antibody Combined Left Lung Consolidation in Chest CT Scan in an Adult Patient Firstly Misdiagnosed as Tuberculosis Proved as Foreign Body Aspiration in the Left Main Stem Bronchus by Bronchoscopy: a Case Report and Literature Review.

作者信息

Ge Yan L, Chen Yi, Wang Meng H, Zhang Qian, Li Wen Q, Liu Cong H, Zhang Hai F, Zhang Shuang, Hao Chen, Zhang Ci, Zhu Xiao Y, Li Li Q, Fu Ai S

出版信息

Clin Lab. 2019 Aug 1;65(8). doi: 10.7754/Clin.Lab.2019.190201.

Abstract

BACKGROUND

Foreign body aspiration is a rare entity in adults. We presented an adult case with recurrent pulmonary infection firstly misdiagnosed as tuberculosis, which proved as foreign body aspiration in the left main stem bronchus by bronchoscopy.

METHODS

Appropriate laboratory tests are carried out. The chest CT scan and bronchoscopy were performed for diagnosis.

RESULTS

Serum sedimentation was increased and tuberculosis antibody was positive. The chest CT scan showed left lung consolidation and small pleural exudate on the left side. Significant calcification can be seen near the left main bronchus. The bronchoscopy demonstrated plenty of yellow sputum in left main bronchus and a peanut shell completely obstructed the left main bronchus and peripheral granulation tissue hyperplasia. The peanut shell was removed and the left main trachea was unobstructed.

CONCLUSIONS

When a patient has recurrent pulmonary infection, especially at the same site, physicians should pay attention to airway obstruction caused by foreign body, cancer and other causes of airway stenosis. Bronchoscopy is crucial for the ultimate diagnosis.

摘要

背景

成人异物吸入较为罕见。我们报告了一例成年患者,反复肺部感染最初被误诊为肺结核,经支气管镜检查证实为左主支气管异物吸入。

方法

进行了适当的实验室检查。行胸部CT扫描和支气管镜检查以明确诊断。

结果

血清血沉升高,结核抗体阳性。胸部CT扫描显示左肺实变及左侧少量胸腔积液。左主支气管附近可见明显钙化。支气管镜检查显示左主支气管内有大量黄色痰液,一个花生壳完全阻塞了左主支气管,周围肉芽组织增生。取出花生壳后,左主气管通畅。

结论

当患者反复肺部感染,尤其是在同一部位时,医生应注意异物、癌症及其他气道狭窄原因导致的气道阻塞。支气管镜检查对最终诊断至关重要。

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