CAJ | 학술논문

目的：提高对肺泡细胞癌间质样肺部病变影像学及临床表现的认识,以减少误诊。方法对3年来在多家医院就诊均误诊为间质性肺纤维化的肺泡细胞癌1例的临床资料进行回顾性分析,并复习相关文献。结果本例因咳嗽、呼吸困难3年,加重1个月入院。有长期木屑吸入史；双侧中下肺均可闻及吸气相爆裂音,胸部CT检查示以左肺为主的间质样改变,曾在多家医院就诊,均诊断为间质性肺纤维化,予相应治疗效果不佳。入我院后经胸腔镜肺活组织病理检查确诊肺泡细胞癌。患者拒绝进一步治疗出院。出院3个月后患者因呼吸困难迅速加重、呼吸衰竭死亡。结论肺泡细胞癌临床表现及肺部病变影像学特征与间质性肺疾病相似,PET、气管镜及经皮肺穿刺病理检查均可能存在假阴性,条件允许者应尽早行肺活组织病理检查,以减少或避免误漏诊。
목적：제고대폐포세포암간질양폐부병변영상학급림상표현적인식,이감소오진。방법대3년래재다가의원취진균오진위간질성폐섬유화적폐포세포암1례적림상자료진행회고성분석,병복습상관문헌。결과본례인해수、호흡곤난3년,가중1개월입원。유장기목설흡입사；쌍측중하폐균가문급흡기상폭렬음,흉부CT검사시이좌폐위주적간질양개변,증재다가의원취진,균진단위간질성폐섬유화,여상응치료효과불가。입아원후경흉강경폐활조직병리검사학진폐포세포암。환자거절진일보치료출원。출원3개월후환자인호흡곤난신속가중、호흡쇠갈사망。결론폐포세포암림상표현급폐부병변영상학특정여간질성폐질병상사,PET、기관경급경피폐천자병리검사균가능존재가음성,조건윤허자응진조행폐활조직병리검사,이감소혹피면오루진。
Objective To highlight the interstitial changes of bronchioloalveolar carcinoma in radiology and clinical manifestations in order to prevent misdiagnosis. Methods The clinical data of a case of bronchioloalveolar carcinoma misdi-agnosed as lung fibrosis for 3 years in other hospitals were respectively reviewed and relevant literature was reviewed. Results A patient with a history of wood dust inhalation admitted to the hospital complied of progressive dry cough and dyspnea at exertion for 3 years. A physical examination revealed bilateral crackles mainly on the left lung, and radiology showed intersti-tial changes mainly on the left lung. A presumptive diagnosis of lung fibrosis was made in several hospitals and corresponding treatment was prescribed, but with no significant clinical improvement. Surgical lung biopsy revealed bronchioloalveolar carci-noma. The patient refused further treatment, and therefore was discharged. The patient died of respiratory failure 3 months lat-er. Conclusion Bronchioloalveolar carcinoma may mimic benign interstitial disease. PET, bronchoscopy and pneumocentesis may possibly be falsely negative,therefore surgical lung biopsy should be performed as soon as possible.