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两例活动性肺结核合并肺癌的病例研究

[Study of two cases of active pulmonary tuberculosis complicated by lung cancer].

作者信息

Fujisawa N, Nagao R, Kimoto K, Katoh O, Sueoka N, Aoki Y, Yamada H

机构信息

Department of Internal Medicine, National Takeo Hospital, Saga, Japan.

出版信息

Kekkaku. 1994 Apr;69(4):323-8.

PMID:8189686
Abstract

In this study, we report on two patients diagnosed with active pulmonary tuberculosis who later developed complications of lung cancer. In both instances, lung cancer was not detected until after cessation of tuberculostatic drugs. Both patients were initially considered to be experiencing exacerbation of pulmonary tuberculosis. Patient 1 was a 77-year-old female. A roentgenogram of her chest revealed a cavitary lesion with infiltration into the right lung field. Her sputum tested positive for acid-fast bacilli. Although she was treated with isoniazid (INH), rifampicin (RFP) and streptomycin sulfate (SM), the RFP and INH treatments had to be discontinued due to liver dysfunction. Her general condition was deteriorated, and pleural effusion appeared on a subsequent chest roentgenogram. Primary squamous-cell lung cancer was confirmed by conducting a transbronchial biopsy. Patient 2 was a 59-year-old male. A roentgenogram of his chest revealed multiple cavitary lesions with infiltration into the bilateral lung field. His sputum also tested positive for acid-fast bacilli. Although he was treated with INH, RFP and SM, INH and RFP treatment had to be discontinued due to liver dysfunction and high fever. The shadow infiltrating the left lung field subsided, but a massive shadow appeared in the right lung field. Primary small-cell lung cancer was confirmed after conducting a sputum cytology. The patients was then administered cisplatin and etoposide. Patient 1 was diagnosed with lung cancer five months after being admitted to the hospital, and Patient 2 ten months after admission. Both patients succumbed due to lung cancer at seven and 26 months, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在本研究中,我们报告了两名被诊断为活动性肺结核的患者,他们后来出现了肺癌并发症。在这两个病例中,直到抗结核药物停用后才检测到肺癌。两名患者最初都被认为是肺结核病情加重。患者1是一名77岁女性。她的胸部X光片显示右肺野有一个空洞性病变并伴有浸润。她的痰液抗酸杆菌检测呈阳性。尽管她接受了异烟肼(INH)、利福平(RFP)和硫酸链霉素(SM)治疗,但由于肝功能障碍,RFP和INH治疗不得不中断。她的一般状况恶化,随后的胸部X光片显示出现了胸腔积液。通过经支气管活检确诊为原发性肺鳞状细胞癌。患者2是一名59岁男性。他的胸部X光片显示双侧肺野有多个空洞性病变并伴有浸润。他的痰液抗酸杆菌检测也呈阳性。尽管他接受了INH、RFP和SM治疗,但由于肝功能障碍和高热,INH和RFP治疗不得不中断。左肺野浸润阴影消退,但右肺野出现了一个大片状阴影。经痰液细胞学检查后确诊为原发性小细胞肺癌。然后对患者使用顺铂和依托泊苷进行治疗。患者1在入院五个月后被诊断为肺癌,患者2在入院十个月后被诊断为肺癌。两名患者分别在七个月和二十六个月时因肺癌死亡。(摘要截断于250字)

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