Casey K R
Section of Pulmonary and Critical Care Medicine, Virginia Mason Medical Center, Seattle, WA 98111, USA.
Semin Respir Infect. 1995 Sep;10(3):131-42.
Several types of neoplastic conditions are included in the differential diagnosis of pneumonia. Bronchial obstruction with cancer can produce obstructive pneumonia that results in intractable infection. Bronchogenic carcinoma and metastatic cancer involving the airways may produce this clinical presentation. Bronchioloalveolar carcinoma is a relatively common form of primary lung cancer that characteristically presents as a chronic infiltrate associated with cough, hypoxemia, shortness of breath, and mucus hypersecretion. This cancer has two distinct histological types with markedly different prognosis. The mucinous variety is much more likely to be multicentric and rapidly progressive whereas the nonmucinous variety may be localized. Lymphoproliferative diseases may also present in an infiltrative appearance. Kaposi's sarcoma infiltrating the lungs, particularly associated with acquired immune deficiency syndrome, presents a diagnostic dilemma because of the high incidence of pulmonary infection in these patients.
肺炎的鉴别诊断包括几种肿瘤性疾病。癌症导致的支气管阻塞可引起阻塞性肺炎，进而导致难治性感染。支气管肺癌和累及气道的转移性癌症可能出现这种临床表现。细支气管肺泡癌是原发性肺癌的一种相对常见的形式，其特征表现为与咳嗽、低氧血症、呼吸急促和黏液分泌过多相关的慢性浸润。这种癌症有两种截然不同的组织学类型，预后明显不同。黏液型更有可能是多中心的且进展迅速，而非黏液型可能是局限性的。淋巴增殖性疾病也可能表现为浸润性外观。浸润肺部的卡波西肉瘤，特别是与获得性免疫缺陷综合征相关的卡波西肉瘤，由于这些患者肺部感染的高发生率，带来了诊断难题。
