21例疑诊为肺癌的新型隐球菌病患者的临床探究  

Pulmonary cryptococcosis suspected as lung cancer:clinical investigation of 21 cases

作　　者：吴峰 华丛书 张朝东 马冬春 Wu Feng;Hua Congshu;Zhang Chaodong;Ma Dongchun(Department of Cardiothoracic Surgery,Anhui Chest Hospital,Hefei 230022,China)

机构地区：[1]安徽省胸科医院胸外一科,合肥230022

出　　处：《中华胸心血管外科杂志》2020年第6期346-350,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨疑诊为肺癌并行手术治疗的新型隐球菌病患者的临床特征,提高对该病的认识及诊治水平。方法回顾性分析2016年2月至2019年7月在安徽省胸科医院胸外科疑诊为肺癌并接受手术治疗的21例新型隐球菌病患者的临床资料,包括术前实验室检查、影像学检查及术后病理等。结果21例患者中17例为单发肺结节,4例为多发肺结节,其中高度怀疑恶性15例,术后病理明确为肺新型隐球菌性肉芽肿性炎。14例患者术后行抗真菌治疗。术后随访患者无复发。结论肺新型隐球菌病患者的临床表现和影像学检查无明显特异性,极易误诊为早期肺癌,需通过定期随访、实验室检查、经皮肺穿刺术或手术活检等多种手段联合才能确诊。Objective To explore the clinical characteristics of cryptococcus neoformans patients who suspected as lung cancer and treated with surgery,and to improve the diagnosis of the disease.Methods A retrospective analysis on clinical data(including preoperative laboratory examination,chest CT imaging and postoperative pathology)of 21 cryptococcosis neoformans patients misdiagnosed as lung cancer in our hospital from February 2016 to July 2019.Results Among the 21 patients,17 cases were single nodules and 4 cases were multiple nodules,among which 15 cases were highly suspected malignancy.The postoperative pathological diagnosis was cryptococcal pulmonary granulomatosis.14 patients were treated with antifungal therapy after surgery.No recurrence was found after postoperative follow-up.Conclusion The clinical manifestations and imaging examination of pulmonary cryptococcus neoformans patients have no obvious specificity,and it is easy to be misdiagnosed as early lung cancer.The diagnosis can only be confirmed by the combination of various means such as regular follow-up,laboratory examination,percutaneous lung puncture or surgical biopsy.

关 键 词：肺隐球菌病 新型隐球菌 肺癌 误诊 

分 类 号：R519.4[医药卫生—内科学]