双肺弥漫性病变伴淋巴结肿大  

Diffuse lung lesions and multiple enlarged lymph nodes:a case report

作　　者：张芮豪 叶寰 滕田璐 许剑钊 冯会颖 唐神结[2] 李亮[2] Zhang Ruihao;Ye Huan;Teng Tianlu;Xu Jianzhao;Feng Huiying;Tang Shenjie;Li Liang(Department of Pulmonary and Critical Care Medicine,Beijing Chest Hospital,Beijing 101125,China;Multidisciplinary Diagnosis and Treatment Centre for Tuberculosis,Beijing Tuberculosis and Thoracic Tumor Research Institute/Beijing Chest Hospital,Beijing 101125,China)

机构地区：[1]首都医科大学附属北京胸科医院呼吸与危重症医学科,北京101125 [2]首都医科大学附属北京胸科医院,北京市结核病胸部肿瘤研究所,结核病多学科诊疗中心,北京101125

出　　处：《中华结核和呼吸杂志》2024年第10期955-959,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：本文报道1例双肺多发弥漫性病变伴有多发淋巴结肿大的老年女性患者, 在诊断早期通过血液、支气管肺泡灌洗液等多样本, 以及细胞免疫、分子生物学等多手段获得诸多结核的线索, 同时进行外周淋巴结活检术后, 通过病理结果初诊即明确为淋巴瘤合并结核的"二元论"诊断。在后续治疗中, 兼顾患者结核感染的控制下积极地进行淋巴瘤治疗, 随访治疗效果良好。在疾病诊断中, 需把鉴别诊断放在诊断的全过程中, 不能固守"一元论"的诊断思路。This article reported a case of an elderly female patient with diffuse lung lesions and multiple enlarged lymph nodes.In the early stages of diagnosis,many clues,obtained through cellular immunology and molecular biology tests on a variety of samples including blood and bronchoalveolar lavage fluid,pointed to the diagnosis of tuberculosis.At the same time,a peripheral lymph node biopsy was conducted,which led to the diagnosis of lymphoma coexisting with tuberculosis,a"dual-diagnosis".In the subsequent treatment,lymphoma therapy was actively pursued while the patient′s tuberculosis infection was treated,with good results observed in the follow-up treatments.When diagnosing the disease,the differential diagnosis must be integrated into the overall disease process,and avoiding rigid adherence to a"unitary"diagnostic concept.

关 键 词：淋巴瘤 结核 弥漫性病变 淋巴结肿大 

分 类 号：R733.1[医药卫生—肿瘤] R521[医药卫生—临床医学]