肺放线菌病误诊为周围型肺癌临床分析

Clinical analysis of four cases of pulmonary actinomycosis misdiagnosed as peripheral lung cancer.

目的探讨肺放线菌病的临床特点，提高对肺放线菌病，临床误诊的认识。方法对我院近年收治的4例肺放线菌病患者临床资料进行分析，总结肺放线菌病的临床与影像学特征及诊断治疗方法，并结合文献进行复习。结果4例均为放线菌感染，但都误诊为肺癌。CT引导下肺穿刺活检、纤维支气管镜检查、外科手术肺叶切除病理可确诊。结论肺放线菌病是临床少见肺部真菌病，易误诊为肺癌，临床医师应提高对肺放线菌病的认识，在肺部占位病变的鉴别诊断中要考虑到肺放线菌病，避免误诊误治，避免不必要的手术损伤。

Objective To investigate the clinical characteristics of pulmonary aetinomycosis and to improve the understanding of the clinical misdiagnosis of pulmonary actinomycosis. Method Clinical data of 4 pulmonary actinomycosis patients were analized and related literatures were reviewed. Results All the 4 pulmonary actinomycosis cases were misdiaguosed as lung cancer. Pulmonary actinomyeosis can be correctly diagnosed through lung biopsy by CT-guided percutaneous paraeentesis, fiberoptie, bronchoscopy, or pathological examination of the resected pulmonary lobe. Conclusions Pulmonary actinomycosis is a rare lung infection caused by fungus, and is liable to be misdiagnosed as peripheral lung cancer. The capacity of distinguishing pulmonary aetinomyeosis from peripheral lung cancer needs to be improved.