肺癌类似于过敏性支气管肺部菌根症,具有类似喘的呈现
Yoshiro Kai1, Ryosuke Kataoka1, Kentaro Suzuki1
1Department of Respiratory Medicine, Minami-Nara General Medical Center, 8-1 Fukugami, Oyodo-cho, Yoshino-gun, Nara, 638-8551, Japan.
Respiratory medicine case reports
|July 12, 2023
概括
过敏性支气管肺部菌 (ABPM) 可以模仿肺癌的症状. 这一案例凸显了当ABPM的临床标准不确时,迅速进行支气管镜检查以确定确诊的重要性.
科学领域:
- 肺部病理学 肺部病理学
- 医学真菌学 医学真菌学
- 在瘤学瘤学.
背景情况:
- 过敏性支气管肺性阿斯伯吉洛症 (ABPA) 是对阿斯伯吉洛菌种的过敏反应.
- 过敏性支气管肺髓菌 (ABPM) 呈现类似,但涉及其他真菌,经常影响患有喘的患者.
- 放射性发现,如支气管切除和粘膜损伤在ABPM中很常见,可能会掩盖其他诊断.
研究的目的:
- 报告一个最初被误诊为ABPM的肺癌病例.
- 强调区分ABPM与肺癌的诊断挑战.
- 强调当临床标准不足时,组织学确认的必要性.
主要方法:
- 一名73岁的男性出现了运动性呼吸障碍,并最初根据CT发现对疑似ABPM进行了评估.
- 诊断ABPM是基于临床标准,忽视了潜在的恶性病变.
- 在持续的症状和瘤的怀疑之后,通过支气管镜检查确诊肺癌.
主要成果:
- 最初被诊断为ABPM的患者随后被发现患有肺癌.
- 在最初的ABPM诊断中,埃索诺菲利亚和高衰减粘液冲击并不是优先考虑的.
- 支气管镜检查证实了肺癌,强调了仅依赖临床ABPM标准的局限性.
结论:
- 将ABPM与肺癌区分开来可能具有挑战性,特别是当典型的放射性发现存在时.
- 在所有情况下,ABPM/ABPA的临床诊断标准可能不足以确定确诊.
- 如果ABPM诊断仍然不确定,医生应立即进行支气管镜检查以进行组织学诊断.
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