小细胞肺癌综合治疗合并复杂肺部影像学改变的分析

Analysis of Complex Pulmonary Imaging Changes After Comprehensive Treatment of Small Cell Lung Cancer

目的:探讨小细胞肺癌(SCLC)治疗后合并肺部影像学异常改变的临床表现、诊断及治疗。方法:对1例就诊于吉林大学第二医院肺部出现复杂影像学异常改变SCLC患者的临床资料进行分析。结果:经过以化疗为主的综合治疗后,患者出现发热、进行性呼吸困难,胸部影像学提示双肺各叶见散在斑片样、条索状高密度影。前期抗感染治疗效果不佳,肺部影像学异常改变进展,后考虑肺部影像学异常改变原因为肺部感染合并间质性肺炎(放射性肺炎、免疫相关性肺炎),调整治疗方案后患者体温下降,肺部影像学异常改变吸收,病情好转出院。结论:SCLC综合治疗后出现肺部影像学异常改变极为常见,应尽早明确病因,制定合理的治疗方案,以免延误病情。

Objective:To investigate the clinical manifestation,diagnosis and treatment of pulmonary imaging abnormal changesafter small cell lung cancer(SCLC) treatment.Methods:The clinical data of a SCLC patient with complex pulmonary imagingabnormal changes in the Second Hospital of Jilin University were analyzed.Results:After the comprehensive treatment based onchemotherapy,the patient developed fever and progressive dyspnea.Chest imaging showed that scattered patch like and cord likehigh-density shadows were seen in each lobe of both lungs.The effect of anti-infection treatment in the early stage was poor,withpulmonary imaging abnormal changes progressing.Considering that the cause of pulmonary imaging abnormal changes waspulmonary infection combined with interstitial pneumonia(radiation pneumonia and immune-related pneumonia),after adjustingthe treatment plan,the patient’s body temperature decreased,the pulmonary imaging abnormal changes were absorbed.And thepatient was discharged from the hospital with the condition improvement.Conclusion:Pulmonary imaging abnormal changes aftercomprehensive treatment of SCLC are very common.It is necessary to clarify the etiology and formulate a reasonable treatmentplan as soon as possible to avoid delaying the disease.