HIV感染合并肺部结节影疑似肺癌一例报道并文献复习  

A case report of suspected lung cancer associated with HIV infection and pulmonary nodule shadow and literature review

作　　者：马彩华 吕玮[1] MA Cai-hua;LV Wei(Chinese Academy of Medical Sciences,Infection Department of Peking Union Medical College Hospital,Beijing 100730 China)

机构地区：[1]中国医学科学院北京协和医院感染科,北京100730

出　　处：《新发传染病电子杂志》2019年第2期108-111,共4页Electronic Journal of Emerging Infectious Diseases

基　　金："十三五"国家传染病重大专项(2017ZX10202102004)

摘　　要：目的探讨HIV感染者合并肺部结节等占位性病变临床鉴别诊断的重要性。方法本文对一例HIV感染合并肺部结节影的患者,从疑似肺癌到临床确诊肺结核的诊治过程进行报道,并对相关文献进行复习。结果一例确诊HIV感染者因发热就诊于门诊,肺部CT可见左肺下叶背段胸膜下结节影,PET-CT提示恶性病变可能性大,行病灶组织活检病理提示慢性炎症。临床考虑肺结核可能给予经验性抗结核治疗及抗反转录病毒治疗,定期随访复查胸部CT,可见结节影较前缩小。随访患者病情稳定。结论 HIV感染者合并肺部结节时,需谨慎鉴别良恶性病变,从而尽早作出正确判断,避免误诊、误治。Objective To explore the importance of the clinical differential diagnosis of HIV infection with pulmonary nodules and other space-occupying lesions.Methods This paper reported the diagnosis and treatment of a patient with HIV infection complicated with pulmonary nodule shadow from suspected lung cancer to clinically confirmed pulmonary tuberculosis,and reviewed relevant literature.Results A patient with confirmed HIV infection was admitted to the outpatient department due to fever.Subpleural nodules of the dorsal segment of the lower lobe of the left lung were observed on lung CT.PET-CT indicated a high possibility of malignant lesions,and biopsy of the lesion tissue suggested chronic inflammation.Clinical consideration of tuberculosis may be given empirical anti-tuberculosis treatment,anti-retrovirus treatment,and regular follow-up review of the chest CT.Visible nodule shadow smaller than before may be obserced.Patients were followed up for stable conditions.Conclusion Among patients with HIV infection complicated with pulmonary nodules,it is necessary to carefully identify benign and malignant lesions so as to make a correct judgment as early as possible and avoid misdiagnosis and treatment.

关 键 词：HIV感染 肺部结节 肺癌 肺结核 

分 类 号：R512.91[医药卫生—内科学]