不明原因发热为首发表现的恶性肿瘤31例

Fever of unknown origin as the first manifestation of malignant neoplasm:analysis of 31 cases

目的探讨以不明原因发热(FUO)为首发表现的恶性肿瘤患者的病因构成特点和诊断难点。方法回顾性分析2003年1—2013年8月住院且符合FUO诊断标准的恶性肿瘤患者31例。男20例,女11例,平均年龄(55.5±16.0)岁。结果 31例患者中,淋巴/造血组织肿瘤26例(83.9%,其中淋巴瘤16例),实体瘤5例(16·1%)。发热程度通常为高热,伴随症状以畏寒、寒战、乏力盗汗、体质量减轻为主;患者具有热程、住院时间、确诊时间长等特点,患者最终确诊与初步诊断不符合18例(58.1%)。结论以FUO为首发表现的恶性肿瘤患者中,淋巴/造血组织肿瘤是最主要的病因,其中淋巴瘤最为常见。长期发热的恶性肿瘤患者容易误诊,在FUO病因诊断中,应警惕恶性肿瘤性疾病的可能。

Objective To explore fever of unknown origin （FUO） as the first manifestation of the characteristics of patients with malignant etiology and diagnosis difficult .Methods Retrospectively analyzed 31 patients with FUO who were hospitalized from January 2003 to August 2013.20 males and 11 females, age （55.5 ＆#177;16.0） years old.Results Among the 31 patients, the lymphatic /hematopoietic tissue tumors in 26 cases （83.9%）, solid tumors of 5 cases （16.1%）.These patients usually had high fever , accompanied by symptoms of chills , chills, fatigue, night sweats and weight loss based ; pa-tients＆#39;fever, hospitalization, diagnosed with longer time.Patients eventually diagnosed with a preliminary diagnosis does not meet in 18 cases （58.1%）.Conclusion Lymphatic /hematopoietic tissue tumor was the most main cause in malignant neo -plasm patients first presenting with FUO, and lymphoma was the main cause of lymphatic /hematopoietic tissue tumor.Malig-nant neoplasm patients of long term fever were easily misdiagnosed ;should be alert to the possibility of tumor diseases in FUO etiology diagnosis.