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胸腔积液细胞学检查及活检结果为阴性在诊断恶性肺部病变中的价值

The Value of a Negative Pleural Fluid Cytology and Biopsy in Diagnosing Malignant Pulmonary Lesions.

作者信息

Egbuchiem Henry C, Onyechi Nkemputaife P, Sakamuri Laxmi P

机构信息

Internal Medicine, University Hospitals Geauga Medical Center, Cleveland, USA.

出版信息

Cureus. 2023 Feb 8;15(2):e34768. doi: 10.7759/cureus.34768. eCollection 2023 Feb.

Abstract

Over 2 million patients developed lung cancer in 2018, and lung malignancy is responsible for an estimated 1.8 million deaths worldwide. Lung cancer diagnosis usually occurs after suspicious symptoms or incidental radiologic findings on chest imaging when the cancer is probably in an advanced stage. Therefore, initial evaluation, diagnosis, staging, and prompt treatment of lung cancer are required to improve pulmonary malignancies' morbidity and mortality rate. Unfortunately, the size of the tumor, the time of imaging, the quality and quantity of pleural fluid, and pleural biopsy all contribute to diagnostic difficulties in evaluating a lung lesion, leaving even the most astute clinician occasionally perplexed. We discuss a case of a female with lung cancer whose diagnosis was challenging because of a negative pleural biopsy, despite initial radiographic imaging suggesting a lung lesion.

摘要

2018年,超过200万患者罹患肺癌,全球估计有180万人死于肺癌。肺癌通常在出现可疑症状或胸部影像学检查偶然发现病变时才得以诊断,此时癌症可能已处于晚期。因此,需要对肺癌进行初始评估、诊断、分期并及时治疗,以提高肺恶性肿瘤的发病率和死亡率。不幸的是,肿瘤大小、成像时间、胸腔积液的质量和数量以及胸膜活检等因素都增加了评估肺部病变的诊断难度,即使是最敏锐的临床医生有时也会感到困惑。我们讨论一例肺癌女性患者,尽管最初的影像学检查提示肺部有病变,但由于胸膜活检结果为阴性,其诊断颇具挑战性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/661c/10001421/215298daf742/cureus-0015-00000034768-i01.jpg

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