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肺结核与肺癌鉴别诊断中的挑战：一例病例报告

Challenges in the differential diagnosis of pulmonary tuberculosis vs. lung cancer: A case report.

作者信息

Luo Tao, Zhang Shuiwang, Li Xiaoliang, Huang Mingxing

机构信息

Central Laboratory, The Third People's Hospital of Zhuhai, Zhuhai, Guangdong 519000, P.R. China.

Department of Tuberculosis, The Third People's Hospital of Zhuhai, Zhuhai, Guangdong 519000, P.R. China.

出版信息

Oncol Lett. 2024 Aug 13;28(4):494. doi: 10.3892/ol.2024.14627. eCollection 2024 Oct.

DOI:10.3892/ol.2024.14627
PMID:39211306
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11358719/
Abstract

Pulmonary tuberculosis (TB) and certain types of lung cancer (LC), such as lung adenocarcinoma, squamous cell carcinoma and small cell undifferentiated carcinoma, are prevalent diseases that share similar clinical symptoms and imaging characteristics, increasing the risk of misdiagnosis. The present report documents the case of a man with a history of close contact with TB who exhibited clinical symptoms and lung CT scan findings that strongly indicated pulmonary TB. However, the diagnosis was ultimately confirmed to be lung adenocarcinoma on endoscopic biopsy. The present report shows that clinicians should always consider the possibility of LC in patients with TB-related pulmonary pathological changes detected by imaging.

摘要

肺结核（TB）和某些类型的肺癌（LC），如肺腺癌、鳞状细胞癌和小细胞未分化癌，是常见疾病，它们具有相似的临床症状和影像学特征，增加了误诊的风险。本报告记录了一名有结核病密切接触史的男性病例，其临床症状和肺部CT扫描结果强烈提示为肺结核。然而，经内镜活检最终确诊为肺腺癌。本报告表明，临床医生对于影像学检查发现有结核相关肺部病变的患者，应始终考虑肺癌的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/519e/11358719/b47292881b18/ol-28-04-14627-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/519e/11358719/5cc109f0bbb8/ol-28-04-14627-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/519e/11358719/9bdcd060594f/ol-28-04-14627-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/519e/11358719/c969cf088220/ol-28-04-14627-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/519e/11358719/9e97ea5656ab/ol-28-04-14627-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/519e/11358719/b47292881b18/ol-28-04-14627-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/519e/11358719/5cc109f0bbb8/ol-28-04-14627-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/519e/11358719/9bdcd060594f/ol-28-04-14627-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/519e/11358719/c969cf088220/ol-28-04-14627-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/519e/11358719/9e97ea5656ab/ol-28-04-14627-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/519e/11358719/b47292881b18/ol-28-04-14627-g04.jpg

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本文引用的文献

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Pulmonary mucinous adenocarcinoma in the presence of reactivated tuberculosis: A case report.合并复发性肺结核的肺黏液腺癌：一例报告
Radiol Case Rep. 2021 Oct 1;16(12):3647-3651. doi: 10.1016/j.radcr.2021.08.070. eCollection 2021 Dec.
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Adenocarcinoma spectrum lesions of the lung: Detection, pathology and treatment strategies.肺腺癌谱系病变：检测、病理学和治疗策略。
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The Diagnosis and Treatment of Tuberculosis.肺结核的诊断与治疗。
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The Value of Combination Analysis of Tumor Biomarkers for Early Differentiating Diagnosis of Lung Cancer and Pulmonary Tuberculosis.肿瘤生物标志物联合分析在肺癌与肺结核早期鉴别诊断中的价值
Ann Clin Lab Sci. 2019 Sep;49(5):645-649.
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Factors for the Early Revision of Misdiagnosed Tuberculosis to Lung Cancer: A Multicenter Study in A Tuberculosis-Prevalent Area.误诊为肺结核的患者早期被修正诊断为肺癌的相关因素：一项在结核病高发地区开展的多中心研究
J Clin Med. 2019 May 17;8(5):700. doi: 10.3390/jcm8050700.
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Multicenter evaluation of the biochip assay for rapid detection of mycobacterial isolates in smear-positive specimens.多中心评估生物芯片检测法在快速检测涂片阳性标本中的分枝杆菌分离株的应用。
Int J Infect Dis. 2019 Apr;81:46-51. doi: 10.1016/j.ijid.2019.01.036. Epub 2019 Jan 24.
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The Relationship between Tuberculosis and Lung Cancer.肺结核与肺癌之间的关系。
Adv Biomed Res. 2018 Mar 27;7:58. doi: 10.4103/abr.abr_182_17. eCollection 2018.
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Identification of Mycobacterium species in direct respiratory specimens using reverse blot hybridisation assay.使用反向斑点杂交分析法鉴定直接呼吸道标本中的分枝杆菌菌种。
Int J Tuberc Lung Dis. 2014 Sep;18(9):1114-20. doi: 10.5588/ijtld.14.0140.
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Pulmonary tuberculosis as differential diagnosis of lung cancer.肺结核作为肺癌的鉴别诊断
South Asian J Cancer. 2012 Jul;1(1):36-42. doi: 10.4103/2278-330X.96507.
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Pulmonary tuberculosis and lung cancer: simultaneous and sequential occurrence.肺结核和肺癌：同时性和先后性发生。
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