CAJ | 학술논문

目的：探讨肺浸润型黏液性腺癌的临床和病理特点，减少误漏诊。方法对我院收治的1例肺浸润型黏液性腺癌的误诊资料进行回顾性分析。结果本例为74岁女性，因咳嗽、咳痰、气促半年余，反复发热半月余入院。CT提示两肺多发结节伴空洞，急诊一度误诊为肺脓肿，给予多种抗生素治疗效果欠佳。复查胸部CT示病变持续进展，于胸外科手术肺活检病理检查确诊为肺浸润型黏液性腺癌，予对症支持和中医药治疗，随访9个月疾病进展，出现多发淋巴结转移和呼吸衰竭。结论临床遇到以肺部多发结节、空洞为主要表现者，除考虑肺部感染性疾病外还需警惕肺癌的可能；治疗后应及时多次复查病灶的影像学变化，对病灶吸收不佳或进展者应尽早行活检病理检查以明确诊断。
목적：탐토폐침윤형점액성선암적림상화병리특점，감소오루진。방법대아원수치적1례폐침윤형점액성선암적오진자료진행회고성분석。결과본례위74세녀성，인해수、해담、기촉반년여，반복발열반월여입원。CT제시량폐다발결절반공동，급진일도오진위폐농종，급여다충항생소치료효과흠가。복사흉부CT시병변지속진전，우흉외과수술폐활검병리검사학진위폐침윤형점액성선암，여대증지지화중의약치료，수방9개월질병진전，출현다발림파결전이화호흡쇠갈。결론림상우도이폐부다발결절、공동위주요표현자，제고필폐부감염성질병외환수경척폐암적가능；치료후응급시다차복사병조적영상학변화，대병조흡수불가혹진전자응진조행활검병리검사이명학진단。
Objective To investigate the pathological and clinical features of lung invasive mucinous adenocarcinoma in order to reduce the misdiagnosis and missed diagnosis rates. Methods Clinical data of one patient with lung invasive mu-cinous adenocarcinoma in our hospital was retrospectively analyzed. Results A 74-year-old female patient complained of hav-ing cough, expectoration and anhelation more than half a year, and fever more than half a month. Chest CT showed bilateral multiple pulmonary cavity and nodules, so she was misdiagnosed as having pulmonary abscess in Emergency Department. She had a variety of antibiotics and the treatment results were not satisfactory. CT showed that the lesion continued to progress, then she was finally diagnosed as having lung invasive mucinous adenocarcinoma by surgical biopsy. Although supporting treat-ment and traditional Chinese medicine were used, the disease progressed in the 9-month follow-up, accompanied by multiple lymph node metastasis and respiratory failure. Conclusion Multiple pulmonary cavity and nodules are not only the main per-formances of pulmonary infectious diseases but can also be observed in certain types of pulmonary carcinoma. Repeated chest CT after treatment should be performed. Early biopsy may be helpful to diagnosis when CT image shows signs of deterioration.