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原发性支气管骨髓肉瘤酷似支气管肺癌:病例报告。

Primary bronchial myeloid sarcoma mimicking bronchogenic carcinoma: a case report.

机构信息

Department of Internal Medicine, the First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Wuhu, 241000, China.

Department of Hematology, the First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Wuhu, 241000, China.

出版信息

BMC Pulm Med. 2019 Nov 8;19(1):204. doi: 10.1186/s12890-019-0975-7.

Abstract

BACKGROUND

Myeloid sarcoma (MS) rarely involves the bronchus, and primary bronchial MS has almost never been reported in mainland China.

CASE PRESENTATION

A 65-year-old female patient was admitted with a 3-month history of cough. She was initially diagnosed with bronchogenic carcinoma according to chest computed tomography (CT). However, after a biopsy was taken from the endobronchial lesion by bronchoscopy and further immunohistochemical analysis was performed, the diagnosis of MS was made. Because her bone marrow was normal and she had no history of haematologic diseases, we further considered the diagnosis of primary bronchial MS. The patient received chemotherapy with HAG regimens, and the original mass completely resolved, as confirmed by chest CT scan after 3 cycles of treatment. Meanwhile, no abnormalities were found on re-examination via bronchoscopy.

CONCLUSIONS

MS should be considered in the differential diagnosis in the presence of a suspicious pulmonary mass. Immunohistochemical analysis is necessary to confirm the diagnosis. Chemotherapy can lengthen the survival time for patients.

摘要

背景

骨髓肉瘤(MS)很少累及支气管,而原发性支气管 MS 在中国大陆几乎从未有报道。

病例介绍

一名 65 岁女性因咳嗽 3 个月而入院。根据胸部计算机断层扫描(CT),最初诊断为支气管癌。然而,支气管镜检查从支气管内病变处取活检并进一步进行免疫组织化学分析后,诊断为 MS。由于她的骨髓正常,且没有血液疾病病史,我们进一步考虑为原发性支气管 MS 的诊断。患者接受 HAG 方案化疗,3 个周期治疗后,胸部 CT 扫描证实原发肿块完全消退。同时,支气管镜复查未见异常。

结论

在存在可疑肺部肿块的情况下,应考虑 MS 作为鉴别诊断。免疫组织化学分析是必要的以确认诊断。化疗可以延长患者的生存时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/28b9/6839095/e0c5f749c775/12890_2019_975_Fig1_HTML.jpg

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