Feng Shan-Li, Li Jun-Yao, Dong Chun-Ling
Department of Respiratory and Critical Care Medicine, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China.
World J Clin Cases. 2024 Jan 16;12(2):354-360. doi: 10.12998/wjcc.v12.i2.354.
There are few cases of pulmonary granulomatous changes secondary to primary biliary cirrhosis (PBC). No case of granulomatous lung disease secondary to PBC misdiagnosed as lung cancer had been reported.
A middle-aged woman presented with lung nodules and was misdiagnosed with lung cancer by positron emission tomography/computed tomography. She underwent left lobectomy, and the pathology of the nodules showed granulomatous inflammation, which was then treated with antibiotics. However, a new nodule appeared. Further investigation with lung biopsy and liver serology led to the diagnosis of PBC, and chest computed tomography indicated significant reduction in the pulmonary nodule by treatment with methylprednisolone and ursodeoxycholic acid.
Diagnosis of pulmonary nodules requires integrating various clinical data to avoid unnecessary pulmonary lobectomy.
原发性胆汁性肝硬化（PBC）继发肺部肉芽肿性改变的病例较少。尚无PBC继发肉芽肿性肺病被误诊为肺癌的病例报道。
一名中年女性出现肺结节，经正电子发射断层扫描/计算机断层扫描被误诊为肺癌。她接受了左肺叶切除术，结节病理显示为肉芽肿性炎症，随后接受抗生素治疗。然而，又出现了一个新的结节。通过肺活检和肝脏血清学进一步检查后诊断为PBC，胸部计算机断层扫描显示，使用甲泼尼龙和熊去氧胆酸治疗后肺结节明显缩小。
肺结节的诊断需要综合各种临床资料，以避免不必要的肺叶切除术。
