以哮喘急性发作为表现的原发性气管腺样囊性癌1例  

A case of primary tracheal adenoid cystic carcinoma characterized by acute asthma

作　　者：辛灵恩 李龙[2] XIN Lingen;LI Long(Department of Basic Medicine,Changzhi Medical College,Changzhi,Shanxi 046000,China;Department of Respiratory,the First Hospital of Lanzhou University,Gansu,Lanzhou 730000,China)

机构地区：[1]长治医学院基础医学部,山西长治046000 [2]兰州大学第一医院呼吸科,甘肃兰州730000

出　　处：《安徽医药》2022年第8期1660-1662,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的加深对气管腺样囊性癌(tracheal adenoid cystic carcinoma,TACC)的疾病特点及诊疗方面的认识,降低漏诊误诊率。方法回顾性分析2018年11月兰州大学第一医院收住入院的1例以哮喘急性发作为表现的原发性气管腺样囊性癌病人的病历资料,查阅并总结分析国内外相关文献资料。结果病人主因“咳嗽、咳痰10 d,加重伴喘息、胸闷4 d”入院,经抗感染、化痰、平喘等对症治疗后病情缓解不明显,电子支气管镜下发现气管肿物,病理活检诊断为气管腺样囊性癌。治疗方案选择“气管肿物切除+隆突重建+纵隔淋巴结清扫术”,术后恢复良好,目前仍在随访中。结论TACC起病隐匿,临床症状缺乏特异性,极易被误诊为支气管炎、哮喘等而被忽略,确诊时间往往比较晚。临床工作中对无慢性肺部疾病的哮喘急性发作病人应警惕气管肿瘤的可能性,及早进行支气管镜检查和病理活检,早诊断早治疗提高病人远期生存率。Objective To deepen the understanding of the disease characteristics,diagnosis and treatment of tracheal adenoid cystic carcinoma(tracheal adenoid cystic carcinoma,TACC),and to reduce the rate of missed diagnosis and misdiagnosis.Methods The medical records of a patient with primary tracheal adenoid cystic carcinoma characterized by acute asthma admitted to the first Hospital of Lanzhou University in November 2018 were retrospectively analyzed,and the relevant literature at home and abroad were reviewed.Results The patient was admitted to hospital mainly because of"cough and expectoration for 10 days,aggravation with wheezing and chest tightness for 4 days".After symptomatic treatment such as anti-infection,resolving phlegm and relieving asthma,the syptoms were not relieved.Trachea mass was found under electronic bronchoscope and was diagnosed by pathological biopsy as tracheal adenoid cystic carcinoma.The treatment plan was"tracheal tumor resection+Carina reconstruction+mediastinal lymph node dissection".The patient recovered well after operation and is still in follow-up.Conclusion TACC has occult onset,and the clinical symptoms are not specific,so it is easy to be misdiagnosed as bronchitis,asthma and so on,and the diagnosis is often late.In clinical practice,patients with acute asthma without chronic lung disease should be aware of the possibility of tracheal tumor,early bronchoscopy and pathological biopsy,early diagnosis and early treatment to improve the long-term survival rate of the patients.

关 键 词：气管肿瘤 哮喘 原发性气管腺样囊性癌 支气管镜 病理活检 早诊断早治疗 

分 类 号：R734.1[医药卫生—肿瘤]