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一名乳腺癌女性患者出现的空洞性肺结节:需谨记“感染”。

Cavitated pulmonary nodules in a female patient with breast cancer: Keep in mind ' infections.

作者信息

Fazio Giulia, Galioto Federica, Ferlito Agata, Coronella Maria, Palmucci Stefano, Basile Antonio

机构信息

Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia" - Radiology Unit I, University Hospital Policlinico "G. Rodolico-San Marco", Via Santa Sofia 78, 95123 Catania, Italy.

出版信息

Respir Med Case Rep. 2021 May 31;33:101441. doi: 10.1016/j.rmcr.2021.101441. eCollection 2021.

Abstract

Serratia species are gram-negative bacteria, which could be isolated from soil, water, plants, animals and air. They are responsible for a heterogeneous spectrum of diseases, affecting the central nervous system, the urinary tract, the respiratory tract and the bloodstream. Pulmonary involvement is rare and typically occurs in immunocompromised patients; radiological appearances include haemorrhagic bronchopneumonia, even with the development of pulmonary abscesses and cavitated parenchymal lesions, or diffuse alveolar damage. Concerning pulmonary cavities, the differential diagnosis should include metastatic lung nodules, rheumatoid arthritis, Langerhans cell histiocytosis, mycotic infections and septic emboli. The knowledge of these radiological features, in association with clinical history and laboratory findings, is mandatory to make the correct diagnosis, suggesting the right treatment and the adequate follow-up. We described a challenging case of a pulmonary infection, which occurred in a patient with breast cancer: clinical features and main imaging findings have been discussed - in order to help clinicians and radiologists in the management of the disease.

摘要

沙雷氏菌属是革兰氏阴性菌,可从土壤、水、植物、动物和空气中分离出来。它们可导致多种不同类型的疾病,影响中枢神经系统、泌尿系统、呼吸道和血液系统。肺部受累较为罕见,通常发生在免疫功能低下的患者中;影像学表现包括出血性支气管肺炎,甚至会发展为肺脓肿和有空洞的实质病变,或弥漫性肺泡损伤。关于肺空洞,鉴别诊断应包括肺转移瘤、类风湿性关节炎、朗格汉斯细胞组织细胞增多症、真菌感染和脓毒性栓子。了解这些影像学特征,并结合临床病史和实验室检查结果,对于做出正确诊断、提出正确的治疗建议和进行充分的随访至关重要。我们描述了一例发生在乳腺癌患者身上的具有挑战性的肺部感染病例:讨论了临床特征和主要影像学表现,以帮助临床医生和放射科医生对该疾病进行管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd4e/8349101/ba7c10a47e45/gr1.jpg

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