盆腔结核误诊为卵巢癌11例分析

目的探讨女性盆腔结核误诊为卵巢癌的原因及预防误诊的措施。方法回顾分析北京大学第一医院1994年12月至2011年1月误诊为卵巢癌的11例盆腔结核患者的临床资料。结果女性盆腔结核多以腹胀、纳差、消瘦、月经紊乱为主诉就诊;结核菌素试验10例阴性;腹水查抗酸杆菌均阴性;6例CA125高于正常;B超检查提示盆腔中到大量积液,9例盆腔可探及包块;6例CT表现为附件区囊实性肿物。初步诊断考虑卵巢癌可能性大,经腹腔镜或开腹探查及活检证实为盆腔结核。结论结合病史,综合运用各种辅助检查手段,必要时通过腹腔镜检查或开腹探查术进行诊断,可提高女性盆腔结核的正确诊断率。

Analysis of 11 cases of pelvic tuberculosis misdiagnosed as ovarian cancer

Objective To investigate the reasons and prevention measures of female pelvic tuberculosis misdiagnosed as ovarian cancer.Methods Eleven cases with pelvic tuberculosis misdiagnosed as ovarian cancer were included in this retrospective study between December 1994 and January 2011.Results Abdominal distension, anorexia, weight loss and menstrual disorders were chief complaints of female pelvic tuberculosis.Tuberculin tests were negative in 10 cases; Acid-fast bacilli in ascites were negative in all cases; CA125 level was above the normal in 6 cases; Pelvic ultrasound prompted to a large number of effusion, and pelvic mass can be explored in 9 cases; CT showed cystic masses of annex in 6 cases.Misdiagnosed as ovarian cancer, pelvic tuberculosis was confirmed by laparoscopy or laparotomy and biopsy.Conclusion Combination with history, comprehensive use of various auxiliary examination methods, and if necessary, diagnostic laparoscopy or laparotomy, the diagnostic accuracy of pelvic tuberculosis can be improved.