1例典型肺炎型肺腺癌的诊治体会  

Diagnosis and treatment of Pneumonia type lung adenocarcinoma:a case report

作　　者：杨勇[1] 常晓悦[1] 姜翠英[1] YANG Yong;CHANG Xiaoyue;JIANG Cuiying(Department of Respiratory and Critical Care Medicine,Baotou Central Hospital,Baotou 014040,China)

机构地区：[1]包头市中心医院呼吸与危重症医学科,内蒙古包头014040

出　　处：《老年医学研究》2020年第1期31-34,共4页Geriatrics Research

摘　　要：患者因咳嗽、咯痰伴气短3个月余,痰量300 mL/d,无发热,经外院两家医院诊断考虑“肺炎”,抗感染治疗无效转入我院。入院后随即完善支气管镜检查,镜下见双侧支气管管腔大量泡沫样痰液填充,右肺为著,右肺各支气管轻度充血。右肺上叶后段行经支气管镜肺活检术,病理回报浸润性腺癌,确诊为肺炎型肺腺癌。给予全身化疗方案及靶向治疗方案后临床症状缓解明显。肺炎型肺癌误诊率高,当遇到咳大量的泡沫样痰或者水样痰液患者,CT提示肺炎样改变,但患者无发热、炎性指标增高不明显、病程转归较社区获得性肺炎更慢时,应警惕肺炎型肺癌可能。The patient had cough,sputum and shortness of breath for more than 3 months,with 300 mL of sputum volume per day,but he did not have a fever.After diagnosis in two hospitals,the patient was considered pneumonia and was transferred to our hospital after ineffective anti-infection treatment.After arriving in our hospital,the bronchoscopy was completed immediately.Under the bronchoscope,a large amount of foamy liquid sputum was filled in the cavities of both bronchial tubes,the right lung was dominated,and the bronchial tubes of the right lung were slightly congested.The posterior segment of the right upper lobe of the lung underwent a bronchoscopy lung biopsy,and the pathological report of invasive adenocarcinoma was diagnosed as pneumonia-type lung adenocarcinoma.The clinical symptoms were significantly relieved after systemic chemotherapy and targeted therapy were given.Pneumonia type lung carcinoma has a high misdiagnosis rate.When encountering a patient who coughs a lot of foamy sputum or watery sputum,CT shows pneumonia-like changes,but the patient has no fever,the inflammatory index is not significantly increased,and the course of the disease is slower than that of community-acquired pneumonia.We should be alert to the possibility of pneumonia type lung carcinoma.

关 键 词：肺炎型肺癌 肺炎 支气管镜 肺活检 

分 类 号：R734.2[医药卫生—肿瘤] R563.1[医药卫生—临床医学]