肺部周围球形病灶误诊原因分析

发布时间：2018-03-26 01:45

本文选题：肺部疾病　切入点：球形病灶　出处：《中国胸心血管外科临床杂志》2012年03期

【摘要】：目的对行影像学检查后误诊的肺部球形病灶进行分析,以期提高对该类疾病的诊断正确率。方法回顾性分析新疆医科大学第一附属医院2006年5月至2011年4月误诊的85例肺部球形病灶患者的临床症状及影像学表现,其中男49例,女36例;中位年龄58(34～75)岁。病灶位于右肺46例,左肺39例,直径2.0～5.6 cm。术前患者均经胸部正侧位X线片检查,并在其后1周内追加胸部CT检查,76例行CT增强扫描。经手术组织病理学检查证实69例,经支气管镜检查证实9例,经穿刺组织病理学检查证实7例。结果肺癌误诊为良性疾病36例(肺结核18例、炎性假瘤12例、肺炎4例、胸膜间皮瘤2例);良性病变被误诊或误诊为肺癌分别为:结核球32例被误诊为肺癌23例、炎性假瘤7例、肺错构瘤2例;肺包虫10例被误诊为肺癌3例、肺结核5例、炎性假瘤2例;炎性假瘤5例被误诊为肺癌1例、肺结核4例;肺错构瘤2例被误诊为肺结核。结论仔细全面分析影像学特征并结合临床症状,合理应用检查方法,可减少肺部球形病变的误诊。
[Abstract]:Objective to analyze the pulmonary spherical lesions misdiagnosed after imaging examination. Methods the clinical symptoms and imaging findings of 85 cases of pulmonary spherical lesions misdiagnosed in the first affiliated Hospital of Xinjiang Medical University from May 2006 to April 2011 were analyzed retrospectively. 36 cases were female; median age was 58 ~ 3475). The lesions were located in the right lung in 46 cases, in the left lung in 39 cases, in the diameter of 2.0 ~ 5.6 cm. In the following one week, 76 cases underwent CT enhanced CT scan, 69 cases were confirmed by histopathology, 9 cases were confirmed by bronchoscopy. Results 36 cases of lung cancer were misdiagnosed as benign diseases (18 cases of pulmonary tuberculosis, 12 cases of inflammatory pseudotumor, 4 cases of pneumonia). 2 cases of pleural mesothelioma, 32 cases of benign lesions were misdiagnosed as lung cancer: 32 cases of tuberculoma were misdiagnosed as lung cancer 23 cases, 7 cases of inflammatory pseudotumor, 2 cases of pulmonary hamartoma, 10 cases of pulmonary hydatid were misdiagnosed as lung cancer in 3 cases, pulmonary tuberculosis in 5 cases, Inflammatory pseudotumor (n = 2), inflammatory pseudotumor (n = 5) were misdiagnosed as lung cancer (n = 1), pulmonary tuberculosis (n = 4) and hamartoma (n = 2) were misdiagnosed as pulmonary tuberculosis. It can reduce the misdiagnosis of pulmonary globular lesion.
【作者单位】：新疆医科大学第一附属医院胸外科;
【分类号】：R447

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