Introduction: The objective of this study was the estimation of the clinical characteristics of patients with pulmonary nontuberculous mycobacterial (NTM) disease complicated by lung cancer during the follow-up period...Introduction: The objective of this study was the estimation of the clinical characteristics of patients with pulmonary nontuberculous mycobacterial (NTM) disease complicated by lung cancer during the follow-up periods. Methods: We analyzed the clinical findings of four patients (2.0%) complicated by lung cancer during the follow-up periods of over six months at least after the definite diagnosis of pulmonary NTM disease of 202 patients with pulmonary NTM disease experienced in our hospital in the last decade. Results: There were four patients with pulmonary NTM disease complicated by lung cancer and all of them were caused by Mycobacterium avium complex (MAC). They were all elderly male patients and had underlying diseases. Three patients were diagnosed with primary lung cancer and one diagnosed with metastatic lung cancer from colon cancer within 3 years after the diagnosis of pulmonary NTM disease. The treatments for lung cancer were surgical resection for all patients with localized lesions. One patient died due to the worsening of underlying disease and the remaining three survived except for the recurrence of one patient. Conclusion: Although the complication rate of pulmonary NTM disease and lung cancer was a lower percentage (2.0%) than in previous reports, the careful follow-up for patients with pulmonary NTM disease without forgetting the possible complication of lung cancer is necessary.展开更多
目的探索影响肺结核治愈但有肺结构性损坏后咳嗽咳痰患者诊断与鉴别诊断的重要因素。方法收集2018年1-12月在广州市胸科医院住院的305例肺结核治愈但有肺结构性损坏、后又因咳嗽咳痰住院治疗患者的临床资料,回顾性分析患者的年龄、性别...目的探索影响肺结核治愈但有肺结构性损坏后咳嗽咳痰患者诊断与鉴别诊断的重要因素。方法收集2018年1-12月在广州市胸科医院住院的305例肺结核治愈但有肺结构性损坏、后又因咳嗽咳痰住院治疗患者的临床资料,回顾性分析患者的年龄、性别、基础性疾病(高血压、糖尿病、慢性阻塞性肺病、支气管张等)、临床症状、胸部影像学、病原学等特征。结果肺部感染、肺结核再发、肺曲霉菌病、非结核分枝杆菌肺病的比例分别为48.52%(148/305)、28.85%(88/305)、13.11%(40/305)和9.51%(29/305),57.70%(176/305)的患者具有支气管张症;4种疾病的男女性别发生率比值分别为1.00 vs.1.38、1.47 vs. 1.00、5.00 vs. 1.00和1.00 vs. 2.00,青年(≤44岁)、中年(45(59岁)、老年(≥60岁)3年龄组发生率比值分别为(1.00∶1.67∶2.13)、(2.00∶1.10∶1.00)、(4.05∶3.03∶1.00)和(0∶1.00∶1.25);呼吸困难、咯血、肺部啰音、发热为主要临床症状和体征,分别占病例总数的42.95%(131/305)、41.64%(127/305)、35.41%(108/305)和20.00%(61/305),其中95.00%(38/40)的肺曲霉菌病患者具有咯血症状;影像学主要表现为密度增高影、钙化、肺大泡、气管偏移、厚壁空洞、胸腔积液、新月征等,分别占病例总数的98.36%(300/305)、75.74%(231/305)、45.90%(140/305)、43.28%(132/305)、41.31%(126/305)、9.18%(28/305)和3.28%(10/305),其中90.00%(9/10)的新月征影像为肺曲霉菌病患者所呈现;病原学或病理学确证率分别为21.62%(32/148)、100%(88/88)、100%(40/40)和100%(29/29)。结论肺结核治愈但致肺结构性损坏后咳嗽、咳痰患者的综合特征是有相类似的临床表现及不易鉴别的影像学表现,所以对于肺结核治愈但有肺结构性损坏后再次出现咳嗽咳痰患者,不能因为具有与结核病相类似的临床症状和影像学表现、更不能因为其有结核病史盲目确立结核病诊断,而应力争获取病原学或病理学证据予以诊断和鉴别诊断。展开更多
文摘Introduction: The objective of this study was the estimation of the clinical characteristics of patients with pulmonary nontuberculous mycobacterial (NTM) disease complicated by lung cancer during the follow-up periods. Methods: We analyzed the clinical findings of four patients (2.0%) complicated by lung cancer during the follow-up periods of over six months at least after the definite diagnosis of pulmonary NTM disease of 202 patients with pulmonary NTM disease experienced in our hospital in the last decade. Results: There were four patients with pulmonary NTM disease complicated by lung cancer and all of them were caused by Mycobacterium avium complex (MAC). They were all elderly male patients and had underlying diseases. Three patients were diagnosed with primary lung cancer and one diagnosed with metastatic lung cancer from colon cancer within 3 years after the diagnosis of pulmonary NTM disease. The treatments for lung cancer were surgical resection for all patients with localized lesions. One patient died due to the worsening of underlying disease and the remaining three survived except for the recurrence of one patient. Conclusion: Although the complication rate of pulmonary NTM disease and lung cancer was a lower percentage (2.0%) than in previous reports, the careful follow-up for patients with pulmonary NTM disease without forgetting the possible complication of lung cancer is necessary.
文摘目的探索影响肺结核治愈但有肺结构性损坏后咳嗽咳痰患者诊断与鉴别诊断的重要因素。方法收集2018年1-12月在广州市胸科医院住院的305例肺结核治愈但有肺结构性损坏、后又因咳嗽咳痰住院治疗患者的临床资料,回顾性分析患者的年龄、性别、基础性疾病(高血压、糖尿病、慢性阻塞性肺病、支气管张等)、临床症状、胸部影像学、病原学等特征。结果肺部感染、肺结核再发、肺曲霉菌病、非结核分枝杆菌肺病的比例分别为48.52%(148/305)、28.85%(88/305)、13.11%(40/305)和9.51%(29/305),57.70%(176/305)的患者具有支气管张症;4种疾病的男女性别发生率比值分别为1.00 vs.1.38、1.47 vs. 1.00、5.00 vs. 1.00和1.00 vs. 2.00,青年(≤44岁)、中年(45(59岁)、老年(≥60岁)3年龄组发生率比值分别为(1.00∶1.67∶2.13)、(2.00∶1.10∶1.00)、(4.05∶3.03∶1.00)和(0∶1.00∶1.25);呼吸困难、咯血、肺部啰音、发热为主要临床症状和体征,分别占病例总数的42.95%(131/305)、41.64%(127/305)、35.41%(108/305)和20.00%(61/305),其中95.00%(38/40)的肺曲霉菌病患者具有咯血症状;影像学主要表现为密度增高影、钙化、肺大泡、气管偏移、厚壁空洞、胸腔积液、新月征等,分别占病例总数的98.36%(300/305)、75.74%(231/305)、45.90%(140/305)、43.28%(132/305)、41.31%(126/305)、9.18%(28/305)和3.28%(10/305),其中90.00%(9/10)的新月征影像为肺曲霉菌病患者所呈现;病原学或病理学确证率分别为21.62%(32/148)、100%(88/88)、100%(40/40)和100%(29/29)。结论肺结核治愈但致肺结构性损坏后咳嗽、咳痰患者的综合特征是有相类似的临床表现及不易鉴别的影像学表现,所以对于肺结核治愈但有肺结构性损坏后再次出现咳嗽咳痰患者,不能因为具有与结核病相类似的临床症状和影像学表现、更不能因为其有结核病史盲目确立结核病诊断,而应力争获取病原学或病理学证据予以诊断和鉴别诊断。
