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伪装成肺癌的慢性嗜酸性粒细胞性肺炎的诊断历程:一例罕见病例报告

Diagnostic journey of chronic eosinophilic pneumonia masked as lung cancer: a rare case report.

作者信息

Katwal Shailendra, Lamsal Sarita, Bhandari Sushmita, Khanal Shital

机构信息

Department of Radiology, Dadeldhura Subregional Hospital, Dadeldhura.

Nepalgunj Medical College, Nepalgunj.

出版信息

Ann Med Surg (Lond). 2023 Sep 22;85(11):5695-5698. doi: 10.1097/MS9.0000000000001296. eCollection 2023 Nov.

Abstract

INTRODUCTION AND IMPORTANCE

Chronic eosinophilic pneumonia (CEP) is an idiopathic condition characterized by unusually high eosinophil infiltration in the lungs' interstitium and alveolar spaces. It is extremely rare, accounting for fewer than 3% of all interstitial lung diseases. CEP is frequently misdiagnosed as lung cancer, which can have catastrophic consequences for sufferers. When assessing patients with lung disease, doctors should be aware of CEP's symptoms and take its prognosis into account because it is a curable disorder.

CASE PRESENTATION

A 40-year-old female presented in the outpatient department of gynecology with a history of abnormal vaginal bleeding for 3 months and mild shortness of breath without any other significant medical history or being under any medications. Physical examination findings were not significant.

CLINICAL DISCUSSION

Ultrasound revealed adenomyosis and a hysterectomy was planned. Chest radiograph revealed lung mass and computed tomography scan showed a well-defined mass with a pleural-based nodule. Histopathology revealed interstitial fibrosis and eosinophilic microabscesses. CEP was diagnosed and oral prednisolone was started with a 0.5 mg/kg/day dose. Chest radiographic abnormalities resolved after one month of treatment. Currently, she is asymptomatic.

CONCLUSION

Early recognition and diagnosis of lung masses are essential for prompt treatment with corticosteroids. CEP can mimic lung malignancy and should be considered in patients with related symptoms.

摘要

引言与重要性

慢性嗜酸性粒细胞性肺炎(CEP)是一种特发性疾病,其特征是肺间质和肺泡腔中嗜酸性粒细胞浸润异常增多。它极为罕见,在所有间质性肺病中所占比例不到3%。CEP常被误诊为肺癌,这可能给患者带来灾难性后果。在评估肺部疾病患者时,医生应了解CEP的症状并考虑其预后,因为这是一种可治愈的疾病。

病例介绍

一名40岁女性因3个月的异常阴道出血病史和轻度气短症状就诊于妇科门诊,无其他重大病史,未服用任何药物。体格检查未发现明显异常。

临床讨论

超声检查发现子宫腺肌病,计划行子宫切除术。胸部X线片显示肺部有肿块,计算机断层扫描显示有一个边界清晰的肿块和一个胸膜下结节。组织病理学检查显示间质纤维化和嗜酸性微脓肿。诊断为CEP,开始口服泼尼松龙,剂量为0.5毫克/千克/天。治疗1个月后胸部X线异常消失。目前,她无症状。

结论

早期识别和诊断肺部肿块对于及时使用皮质类固醇治疗至关重要。CEP可模仿肺部恶性肿瘤,有相关症状的患者应考虑该病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5870/10617855/8a6fc57e21e6/ms9-85-5695-g001.jpg

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