肺曲菌球病21例临床分析

Clinical analysis on 21 cases with pulmonary aspergilloma

目的总结肺曲菌球病的临床特点。方法回顾性分析21例肺曲菌球病患者的临床资料。结果肺曲菌球病症状多表现为反复咳嗽、咳痰、咯血等;影像学主要表现为球状影合并空洞9例,团块或结节影12例;确诊方法:经外科手术病理确诊18例,经纤维支气管镜镜下支气管黏膜活检确诊3例;21例肺曲菌球病中9例误诊,误诊率达42.9%,误诊为肺结核、肺癌、支气管扩张。结论肺曲菌球病临床表现无特异性,多有原发病,容易造成误诊。确诊主要依赖于病理学检查。目前手术仍是肺曲菌球病的主要治疗方法,抗真菌药治疗效果欠佳。

Objective To summarize the clinical features of pulmonary aspergilloma.MethodsClinical date of 21 patients with pulmonary aspergilloma were analyzed retrospectively.Results The main symptoms of pulmonary aspergilloma were cough,expectoration and emptysis.The imaging features were ball shadow with cavitary shadow in 9 cases and ball or nodular shadows in 12 cases.Pulmonary aspergilloma was diagnosed by surgery in 18 cases,by biopsy via bronchofibroscope in 3 cases.Misdiagnosis rate was 42.9%（9 cases）,which was commonly misdiagnosed as lung tuberculosis or bronchiogenic cancer.Conclusion The symptoms of pulmonary aspergilloma is not typical.Majority of patients have the primary disease and are easily to be misdiagnosed.The diagnosis of pulmonary aspergilloma depends on pathological examination.Surgery is still the main treatment for pulmonary aspergilloma and antifungal agents are not ideal in treating pulmonary aspergilloma.