CAJ | 학술논문

目的：分析Pancoast综合征患者的临床特点并探讨肌电图在其早期诊断中的意义。方法：回顾2012年6月至2014年4月收治的2例Pancoast综合征患者，对其肌电图、胸部CT、颈胸部MRI或PET-CT以及病理活检结果进行分析。结果：1例胸部CT及胸椎MRI提示右上肺占位，考虑右肺上沟癌侵犯邻近椎体及其附件，肌电图表现为下臂丛神经损害。另外1例颈椎MRI提示C4-7椎间盘突出，PET/CT提示左胸廓顶部高代谢软组织肿块，侵犯邻近胸壁伴T1-2、第1、第2肋骨质破坏，肌电图表现为C8-T1神经根性损害。本研究2例患者病理检查均确诊为非小细胞肺癌，均表现为Pancoast综合征。结论：Pancoast综合征常见于肿瘤及感染性疾病，首发症状可能仅表现为肩背部疼痛，容易造成误诊，而肌电图对其早期诊断有一定的辅助作用。
목적：분석Pancoast종합정환자적림상특점병탐토기전도재기조기진단중적의의。방법：회고2012년6월지2014년4월수치적2례Pancoast종합정환자，대기기전도、흉부CT、경흉부MRI혹PET-CT이급병리활검결과진행분석。결과：1례흉부CT급흉추MRI제시우상폐점위，고필우폐상구암침범린근추체급기부건，기전도표현위하비총신경손해。령외1례경추MRI제시C4-7추간반돌출，PET/CT제시좌흉곽정부고대사연조직종괴，침범린근흉벽반T1-2、제1、제2륵골질파배，기전도표현위C8-T1신경근성손해。본연구2례환자병리검사균학진위비소세포폐암，균표현위Pancoast종합정。결론：Pancoast종합정상견우종류급감염성질병，수발증상가능부표현위견배부동통，용역조성오진，이기전도대기조기진단유일정적보조작용。
Objective: To investigate the clinical feature of pancoast syndrome, summarizing its causes and exploring the signiifcance of electromyography in the early diagnosis.Methods: Two patients of pancoast syndrome were diagnosed in our hospital from June 2012 to April 2014, electromyogram (EMG), chest CT, neck and chest MRI or PET-CT and biopsy were performed and summarized.Results: Chest CT and thoracic MRI of one case revealed a superior sulcus tumour with an invasion of the adjacent vertebral body and appendix, EMG suggested a lower brachial plexopathy. Cervical MRI of the other case revealed a protrusion of C4-7 cervical intervertebral disc, a PET/CT scan showed obvious increased FDG uptake in the apex of the left hemithorax ex-tending into the adjacent chest wall, T1-2 vertebral body and T1-2 ribs, EMG suggested isolated C8-T1 cervi-cal radiculopathy. Both of 2 cases were conifrmed by biopsy with a poorly differentiated non-small-cell lung car-cinoma, presenting with pancoast syndrome.Conclusion: Main causes of Pancoast syndrome are neoplasms and infectious processes. The special initial clinical manifestation of Pancoast syndrome with shoulder and back pain is responsible for the observed delay in diagnosis. EMG plays a possible ancillary role in directing the course of diagnosis in challenging cases of Pancoast syndrome.