Department of Respiratory Medicine and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Respiratory Medicine, Qingyang Hospital of Traditional Chinese Medicine, 745000, Qingyang, Gansu, China.
BMC Pulm Med. 2024 Apr 12;24(1):175. doi: 10.1186/s12890-024-02975-1.
Interstitial lung disease (ILD) can lead to lung cancer, which brings great challenges to differential diagnosis and comprehensive treatment. However, the clinical features of lung-dominant connective tissue disease (LD-CTD) related ILD combined with lung cancer has not been validated. We report the case of an 80-year-old woman with LD-CTD treated regularly with nintedanib who presented progressive dyspnoea and hypoxemia after recurrent viral infections. Her chest computed tomography (CT) showed aggravated interstitial fibrosis in both lower lungs with moderate right pleural effusion. Clinicians should be alert to lung cancer in patients who are experiencing poor responsiveness to treatment or acute progression of ILD. The available literatures about the differential diagnosis of clinical manifestations, imaging, treatment and prognosis of LD-CTD are reviewed and discussed in this study.
间质性肺疾病（ILD）可导致肺癌，给鉴别诊断和综合治疗带来巨大挑战。然而，肺为主型结缔组织病（LD-CTD）相关的ILD 合并肺癌的临床特征尚未得到验证。我们报告了一例 80 岁女性 LD-CTD 患者，定期接受尼达尼布治疗，在反复病毒感染后出现进行性呼吸困难和低氧血症。她的胸部计算机断层扫描（CT）显示双下肺间质纤维化加重，伴有中等量右侧胸腔积液。临床医生应警惕对治疗反应不佳或ILD 急性进展的患者出现肺癌。本文对 LD-CTD 的临床表现、影像学、治疗和预后的鉴别诊断的相关文献进行了回顾和讨论。
