摘要
目的探讨肺炎性假瘤(pulmonary inflammatory pseudotumor,PIP)的临床及病理特征,以提高鉴别诊断水平。方法回顾性分析我院2002—2012年经病理检查确诊的14例PIP误诊病例的临床资料,并进行文献复习。结果本组无明显症状3例,体检时发现肺内占位性病变;咳嗽、咳痰9例;痰中带血及咯血4例;发热3例;胸闷、胸痛各1例;查体肺内可闻及湿性啰音1例,余均无明显肺部体征。14例就诊初期均误诊,误诊率100%。1例因胸部CT表现为厚壁空洞初诊误诊为肺脓肿,余13例均误诊为肺癌。平均误诊时间2周。14例均行手术治疗,皆经病理检查确诊为PIP。结论临床上PIP应与肺癌相鉴别,并需综合分析临床资料进行判断,确诊主要依靠手术病理检查,治疗以手术切除为主。
Objective To explore clinical features and pathological characteristics of pulmonary inflammatory pseudotumor（PIP） in order to improve differential diagnosis.Methods Clinical data of 14 misdiagnosed patients with PIP in our hospital from 2002 to 2012 were retrospectively analyzed,and related literature were also reviewed.Results Among the 14 patients,3 patients were asymptomatic with pulmonic occupying lesions found by physical check up;9 patients with cough and expectoration;4 with blood in sputum and hemoptysis;3 with fever;1 with chest pain;1 with dyspnea and 1 with moist rales,and no obvious signs were found in other patients.All the patients were misdiagnosed,and the misdiagnosis rate was 100%.One patient was misdiagnosed as having pulmonary abscess because of thick walled cavity by CT,and thirteen patients were misdiagnosed as having lung cancer.The average misdiagnosed time was 2 weeks.The 14 patients underwent operations,and were definitely diagnosed as having PIP by pathological results.Conclusion PIP is often identified with lung cancer.The comprehensive analysis of clinical data is helpful to improve the PIP diagnosis,and definite diagnosis depends on surgical pathology.The preferred method of PIP treatment is surgery.
出处
《临床误诊误治》
2013年第7期67-69,共3页
Clinical Misdiagnosis & Mistherapy
关键词
肉芽肿
浆细胞
肺
肿瘤
肌组织
误诊
肺肿瘤
Granuloma
Plasma cell
lung
Neoplasm
Muscle tissue
Misdiagnosis
Lung neoplasm
