1例误诊为肺栓塞的局灶性机化性肺炎并文献复习  

One case of focal organizing pneumonia of misdiagnosing as pulmonary embolism with literature review

作　　者：倪力[1] 韩锋锋[1] 张悦[1] 戈霞晖[1] 管雯斌[2] 郭雪君[1] 

机构地区：[1]上海交通大学医学院附属新华医院呼吸科,上海200092 [2]上海交通大学医学院附属新华医院病理科,上海200092

出　　处：《国际呼吸杂志》2012年第12期887-890,共4页International Journal of Respiration

摘　　要：目的：探讨局灶性机化性肺炎的临床特征、鉴别诊断及治疗。方法分析就诊于上海交通大学医学院附属新华医院呼吸科的1例经肺活检病理明确的局灶性机化性肺炎患者的临床资料，并结合文献进行复习。结果局灶性机化性肺炎发病率低，可有咳嗽、咯痰、咯血、胸痛、发热等多种临床表现，影像学上缺乏特异性，主要表现为孤立的局限性病灶。明确诊断主要依靠病理。治疗则以应用糖皮质激素为主。结论局灶性机化性肺炎实际是肺部病变的一种病理状态，它多由肺内感染性疾病等多种因素导致肺部改变的一种共同表现，其表现常需与周围型肺癌鉴别，有时也可出现类似肺栓塞的表现，需要临床综合分析做出判断。Objective To discuss the clinical features, differential diagnosis and treatment of a patient with focal organizing pneumonia （FOP）. Methods One case of FOP confirmed by pathology of right lung biopsy in our hospital was reported, while the literatures were reviewed. Results FOP is a relatively rare interstitial lung disease, may have cough, sputum, hemoptysis, chest pain, fever and other clinical manifestations. The radiological features of FOP lack of specificity, mainly isolated pulmonary. Pathologic examination of lung tissue biopsy is required for confirmation of FOP. The main treatment is corticosteroids via intravenous or oral. Conclusions FOP is a pathological state of lung disease, which is a common performance resulted from the pulmonary infectious diseases and other factors. Its performance often needs to identify with peripheral lung cancer, and sometimes may appear similar to the performance of pulmonary embolism. So we need to make a comprehensive analysis of clinical judgments.

关 键 词：局灶性机化性肺炎 肺栓塞 诊断 肺活检 

分 类 号：R563.1[医药卫生—呼吸系统]