Tanimura S, Tomoyasu H, Bamba J, Masaki M, Matsushita H
Department of Chest Surgery, Toranomon Hospital, Tokyo, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Nov;46(11):1137-40. doi: 10.1007/BF03217889.
Pulmonary embolism is commonly misdiagnosed as lung cancer, since sputum cytological tests often show atypical or malignant cells. We report three operated cases of pulmonary embolism incorrectly diagnosed as lung cancer. The first patient is a 39-year-old male with chest pain an bloody sputum. Chest x-ray revealed abnormal shadows and subsequent sputum cytological tests identified malignant cells. The second patient is a 63-year-old male with the same diagnostic pattern as the first case. The third patient is a 72-year-old male whose routine chest x-ray showed an abnormal shadow; malignant cells were identified by cytological tests on transbronchial fiberscope brushings. These three patients were histopathologically diagnosed as suffering pulmonary embolism by wedge resection under thoracotomy. When a patient has chest pain or bloody sputum with showing temporarily malignant cells on cytology, the possibility of pulmonary embolism should be taken into consideration.
肺栓塞常被误诊为肺癌，因为痰细胞学检查常显示非典型或恶性细胞。我们报告了3例被误诊为肺癌的肺栓塞手术病例。首例患者为一名39岁男性，有胸痛和咯血症状。胸部X线显示异常阴影，随后的痰细胞学检查发现了恶性细胞。第二例患者为一名63岁男性，诊断模式与第一例相同。第三例患者为一名72岁男性，常规胸部X线显示异常阴影；经支气管纤维镜刷检的细胞学检查发现了恶性细胞。这3例患者经开胸楔形切除术组织病理学诊断为肺栓塞。当患者有胸痛或咯血且细胞学检查显示暂时为恶性细胞时，应考虑肺栓塞的可能性。
