肺结核合并肺癌的影像和临床特点及误诊原因分析

目的：总结肺结核合并肺癌的临床和影像学特点，以提高诊断水平，减少误诊。方法：回顾2001年1月-2008年1月期间确诊为肺结核合并肺癌以及初诊分别为肺结核和肺癌而进一步确诊为肺癌和肺结核病的临床和影像资料。结果：在收治的15660例肺结核病人中，肺结核合并肺癌182例（1．16%），其中肺癌病灶发生在肺结核所在肺叶或肺段63例；临床诊断为肺癌而行剖胸探查的2588例病人术后病理确诊为肺结核合并肺癌22例（0．85％）。主要症状为刺激性咳嗽、发热、盗汗等。肺部影像表现为偏心空洞、肿块周围毛刺状、肺不张以及胸腔积液等，同时也具有各型肺结核的影像特点。结论：肺结核合并肺癌以及肺结核与肺癌的临床鉴别诊断在临床上较为困难，应认真进行相关辅助检查以防止误诊、漏诊。

Image and clinical characteristic of lung cancer complicated with pulmonary tuberculosis

Objective:To summarize the clinical and imaging characteristics of lung cancer complicated with pulmonary tuberculosis.Methods:Clinical data of patients with analysed lung cancer complicated with pulmonary tuberculosis was.Results:Among 15660 cases of pulmonary tuberculosis patients,lung cancer complicated with pulmonary tuberculosis were 182 cases(1.16%).The main symptoms were irritative cough,low fever,night sweat,breathlessness and pain.Conclusion:It is not unusual event that lung cancer and pulmonary tuberculosis were simultaneously diagnosed in the same patient.When new symptoms appeared or aggravated,and abnormal imaging changes were observed,the simultaneous occurrence of lung cancer and pulmonary tuberculosis should be very highly suspected.