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表现为大咯血和血胸的伴曲霉感染的肺隔离症,胸腔积液中癌胚抗原显著升高,类似于晚期肺癌。

Pulmonary sequestration with Aspergillus infection presenting as massive hemoptysis and hemothorax with highly elevated carcinoembryonic antigen in pleural effusion that mimics advanced lung malignancy.

机构信息

Department of Respiratory and Critical Care Medicine, The People's Hospital of Leshan, Leshan, 614000, Sichuan, China.

Department of Thoracic Surgery, The People's Hospital of Leshan, Leshan, 614000, Sichuan, China.

出版信息

Eur J Med Res. 2021 May 25;26(1):48. doi: 10.1186/s40001-021-00519-5.

Abstract

BACKGROUND

Pulmonary sequestration (PS) associated with massive hemoptysis, hemothorax, and elevated tumor markers or even lung malignancy has been reported in several studies. These clinical features combined with lung lesions on chest imaging are sometimes hard to differentiate from lung malignancies and often complicate the diagnostic procedure.

CASE PRESENTATION

A 45-year-old man with PS presented with massive hemoptysis, hemothorax, and extremely elevated carcinoembryonic antigen (CEA) in pleural effusion was initially misdiagnosed with advanced lung carcinoma, but was ultimately diagnosed with PS with Aspergillus infection.

CONCLUSIONS

PS is rarely concurrent with lung cancer; most of the time, it is misdiagnosed as a malignancy, especially when presenting with a fungal infection, which could remarkably elevate CEA in pleural effusion.

摘要

背景

已有研究报道,肺隔离症(PS)可并发大咯血、血胸、肿瘤标志物升高,甚至肺癌。这些临床表现结合胸部影像学上的肺部病变,有时很难与肺癌相鉴别,常使诊断过程复杂化。

病例介绍

一位 45 岁男性,因 PS 并发大咯血、血胸,胸腔积液中癌胚抗原(CEA)显著升高,最初被误诊为晚期肺癌,但最终诊断为并发曲霉菌感染的 PS。

结论

PS 很少与肺癌同时发生;大多数情况下,PS 被误诊为恶性肿瘤,尤其是当并发真菌感染时,胸腔积液中的 CEA 会显著升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f3d/8146657/9adc05a87b51/40001_2021_519_Fig1_HTML.jpg

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