肺部放线菌病酷似肺癌的 F-氟代脱氧葡萄糖正电子发射断层扫描表现：一例报告。
Pulmonary actinomycosis mimicking lung cancer on F-fluorodeoxyglucose positron emission tomography: a case report.
机构信息
Department of Respiratory Medicine, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi-shi, Mie, 510-0822, Japan.
Department of Orthopaedic Surgery, Yokkaichi Municipal Hospital, 2-2-37, Shibata, Yokkaichi-shi, Mie, 510-0822, Japan.
出版信息
J Med Case Rep. 2022 Jul 1;16(1):255. doi: 10.1186/s13256-022-03481-w.
BACKGROUND
Pulmonary actinomycosis is a chronic disease characterized by abscess formation, draining sinuses, fistulae, and tissue fibrosis. It can mimic other conditions, particularly malignant and granulomatous diseases, and is perhaps extremely challenging to diagnose.
CASE PRESENTATION
A 64-year-old Japanese man presented with 6-week history of a painful solid lump in the chest wall. Chest computed tomography scan revealed a mass-like consolidation in the left upper lobe, with rib erosion and direct extension into the anterior chest wall. F-fluorodeoxyglucose positron emission tomography scan showed increased metabolic activity in the mass, which is indicative of primary lung cancer. The bronchoscopy and computed tomography scan-guided transthoracic biopsy results were considered nondiagnostic. Finally, the patient was diagnosed with pulmonary actinomycosis via surgical resection. He completed an 8-week course of antibiotic therapy and experienced no recurrence.
CONCLUSIONS
There is no difference in positron emission tomography/computed tomography scan findings between actinomycosis and malignancy. Therefore, pulmonary actinomycosis should be considered in the differential diagnosis of cases involving intensive activity on F-fluorodeoxyglucose positron emission tomography scan.
背景
肺放线菌病是一种以脓肿形成、窦道、瘘管和组织纤维化为特征的慢性疾病。它可以模仿其他疾病，特别是恶性和肉芽肿性疾病，因此诊断极具挑战性。
病例介绍
一名 64 岁的日本男性因胸痛性肿块就诊，病史 6 周。胸部计算机断层扫描显示左上叶肿块样实变，伴有肋骨侵蚀和直接向前胸壁延伸。氟代脱氧葡萄糖正电子发射断层扫描显示肿块代谢活性增加，提示原发性肺癌。支气管镜和计算机断层扫描引导下经胸活检结果考虑为非诊断性。最终，通过手术切除确诊为肺放线菌病。他接受了 8 周的抗生素治疗，没有复发。
结论
放线菌病和恶性肿瘤的正电子发射断层扫描/计算机断层扫描结果没有差异。因此，在氟代脱氧葡萄糖正电子发射断层扫描显示高代谢活动的病例中，应考虑肺放线菌病的鉴别诊断。
Zotero 插件