原发性肺动脉肉瘤误诊为肺血栓栓塞症原因分析

目的提高对原发性肺动脉肉瘤（PAS）的认识和早期诊治率。方法结合3例肺动脉肉瘤患者的的临床资料和国外有关文献,对肺动脉肉瘤及肺血栓栓塞症（PTE）的临床特点进行分析。结果肺动脉肉瘤的临床表现和肺血栓栓塞症相似,但前者多有发热、体重下降,无下肢深静脉血栓形成,胸部增强CT显示肺动脉扩张,主肺动脉及左、右肺动脉内大量肿块阴影,管腔外肿块阴影,溶栓抗凝治疗无效等,确诊需手术。结论肺动脉肉瘤易误诊为肺血栓栓塞症,临床医师应提高认识。     

原发性肺动脉肉瘤3例临床特征

目的 提高对原发性肺动脉肉瘤(PAS)的认识和早期诊治率.方法 结合首都医科大学附属北京安贞医院2001-10-26-2007-06-05收治的3例手术病理证实的肺动脉肉瘤患者的临床资料和有关文献,对肺动脉肉瘤的临床表现、诊断和治疗方法进行分析.结果 肺动脉肉瘤的临床表现和肺血栓栓塞症相似,CT肺动脉造影、彩色多普勒超声心动图等有助于诊断,确诊需手术.手术是治疗肺动脉肉瘤的主要方法.结论 肺动脉肉瘤易被误诊为肺血栓栓塞症,临床医生应提高认识,以早期诊断和治疗肺动脉肉瘤.     

肺动脉肉瘤误诊为肺血栓栓塞症三例原因分析

目的　提高对肺动脉肉瘤的认识及正确诊断率。方法　结合 3例肺动脉肉瘤患者的临床资料和有关文献对肺动脉肉瘤及肺血栓栓塞症 (PTE)的临床特点进行对比分析。结果　肺动脉肉瘤与肺血栓栓塞症临床表现相似 ,但肺动脉肉瘤患者发病隐匿 ,多有发热、体重减轻 ,无下肢深静脉血栓形成病史 ,影像学显示单侧肺动脉扩张 ,主肺动脉及左、右肺动脉内大量肿块 ,临床上经溶栓和抗凝治疗后病情仍恶化 ,确诊需手术。结论　肺动脉肉瘤易误诊为PTE ,需引起临床注意     

原发性肺动脉肉瘤的诊治进展

原发性肺动脉肉瘤是一种起源于肺动脉并主要累及肺循环的罕见肿瘤,其临床表现多样且无特异性,易复发和转移.本病与慢性肺血栓栓塞疾病在临床和影像学表现方面存在相似性而容易混淆,不同影像学诊断方法联合有助于提高术前诊断率.治疗以手术为主,联合化疗和放疗可延长生存期.本病总体预后差,与肿瘤切除程度、病理类型等相关.     

肺动脉肉瘤误诊为肺血栓栓塞症1例病例报道并文献复习

<正>肺动脉肉瘤是起源于肺动脉内膜的罕见恶性肿瘤,临床上极少见,医师对其认识严重不足,同时因肺动脉肉瘤临床表现、影像学检查等与肺血栓栓塞症相似,临床上极易将肺动脉肉瘤误诊为肺血栓栓塞症,从而延误患者的治疗。本文报导1例误诊为肺血栓栓塞症的原发性肺动脉肉瘤患者,并结合相关文献进行分析,以提高临床医师对本病的诊治水平。     

原发性肺动脉肉瘤1例并文献复习

目的 提高对原发性肺动脉肉瘤的认识和诊断水平。方法 结合我院1例经手术病理证实的原发性肺动脉肉瘤患者的临床资料与国内外有关文献,对原发性肺动脉肉瘤的临床表现、影像学表现、实验室检查结果进行分析。结果 原发性肺动脉肉瘤的临床表现与肺动脉血栓栓塞相似,应用CT肺动脉造影鉴别有一定局限性,正电子发射型计算机断层扫描与CT合用有助于诊断。结论 原发性肺动脉肉瘤临床表现及常规影像特异性较少,正电子发射型计算机断层扫描与CT结合有更大的诊断价值。     

肺动脉肉瘤致右肺动脉主干完全堵塞1例

正肺动脉肉瘤为罕见疾病,最早于1923年Moritz首次报道。本文报道1例经手术后病理证实为肺动脉肉瘤,分析如下:一般临床资料患者女性,51岁,因发热、咳嗽及咳痰伴胸痛3个月入住我院,入院查体:双肺呼吸音清晰,未闻及干湿性啰音;心率83次/min,律齐,各瓣膜听诊区未闻及病理性杂音。辅助检查:2015年7月入院后查:双肺增强CT考虑肺动脉栓塞。全身PET-CT检查示:肺动脉主干,左肺动脉起     

肺动脉肉瘤与累及中央肺动脉的慢性肺栓塞CT鉴别初探

目的:提高对原发性肺动脉肉瘤的CT影像特征的认识及其与慢性肺动脉血栓栓塞的鉴别能力。方法:回顾性纳入2009年8月至2019年7月中国医学科学院阜外医院经手术后病理确诊的原发性肺动脉肉瘤（PAS组）和累及中央肺动脉的慢性肺动脉血栓栓塞（CPTE组）的患者资料。PAS组13例,其中男10例,女3例,年龄（45.4±15....     

慢性血栓栓塞性肺动脉高压的临床研究进展

慢性血栓栓塞性肺动脉高压是一种较为常见的疾病,虽然目前认为慢性血栓栓塞性肺动脉高压是急性肺栓塞的一种临床结局,但部分慢性血栓栓塞性肺动脉高压患者并无明确肺栓塞病史.由于临床医师对此疾病的认识尚不够深入,故往往是在对呼吸困难患者进行超声心动图检查时才怀疑此疾病.慢性血栓栓塞性肺动脉高压的确诊依赖于通气/灌注肺扫描和肺动脉造影.本文对慢性血栓栓塞性肺动脉高压的发病机制、危险因素和临床表现以及诊断研究进展进行综述.     

原发性肺动脉肉瘤误诊误治原因分析

目的 提高对原发性肺动脉肉瘤的认识,减少误诊、误治.方法 结合北京安贞医院2001年10月至2009年3月手术病理证实的4例原发性肺动脉肉瘤患者的的临床资料和国外有关文献,对原发性肺动脉肉瘤的误诊、误治原因进行分析.结果 原发性肺动脉肉瘤的临床表现和肺血栓栓塞症相似,主要有活动性呼吸困难/气促、胸闷、胸痛、咳嗽、咯血、晕厥等,无特异性;彩色多普勒超声心动图显示右心扩大,三尖瓣返流.肺动脉高压,右室流出道及主肺动脉内团块样异常回声;多普勒血管超声显示下肢静脉正常;CT肺动脉造影显示肺动脉扩张,管腔狭窄,主肺动脉及左、右肺动脉内大块充盈缺损等.4例患者术前全部误诊为肺栓塞,给予溶栓抗凝治疗,疗效不佳.手术后死亡1例,3例存活者病情缓解,无一例辅助放疗和(或)化疗.结论 原发性肺动脉肉瘤临床上少见,易误诊为肺栓塞给予溶栓抗凝治疗,确诊需手术,手术为主的综合治疗是治疗此病的有效手段.     

Primary pulmonary artery rhabdomyosarcoma

A 69-year-old woman presented with a 4-month history of dyspnoea and radiating upper-right quadrant pain and oedema in her lower extremities for more than 20 days. The ultrasonographic study of the heart revealed the adherence of a substantive hypoechoic mass (73 x 34 mm) to the antelateral wall of the pulmonary artery and resultant pulmonary stenosis. Computed tomographic imaging of the pulmonary artery revealed an irregularly shaped filling defect (approximately 41 x 39 x 59 mm) in the main pulmonary artery. The boundary of the defect was irregular, but demarcation with healthy tissue was clear. After surgical treatment, the histologic and immunohistochemical assays revealed a primary pulmonary artery rhabdomyosarcoma. Pulmonary artery rhabdomyosarcomas are usually misdiagnosed as other pulmonary artery obstructive diseases. There should be a greater focus of clinical attention and resection is the appropriate surgical treatment for such malignant tumours.     

Pulmonary artery sarcoma masquerading as saddle pulmonary embolism

Pulmonary artery sarcoma is a highly malignant tumour. Therefore, making the diagnosis is very important. We describe a case which presented with dyspnea on exertion and was initially diagnosed as saddle pulmonary embolism per CT thorax with contrast. Despite adequate anticoagulation, symptoms still progressed. Follow-up CT thorax showed an extension of the presumed filling defect or clots into the left main pulmonary artery with new lung nodules. This prompted suspicion that this may not be a pulmonary embolism. Biopsy of the lung nodule revealed high grade soft tissue sarcoma with primary source from the pulmonary artery. Our case highlights that pulmonary artery sarcoma should always be included in the differential diagnosis of pulmonary embolism especially, if symptoms still progress while on adequate anticoagulation, or any pulmonary nodules develop on follow-up exam.     

Pulmonary artery sarcoma: a case report of surgical cure and 5-year follow-up

Pulmonary artery sarcoma is a rare tumor that is frequently misdiagnosed as chronic pulmonary embolism. With heightened clinical awareness and advancement in technology, the diagnosis is now increasingly being made preoperatively. Previous literature has described the disease to be uniformly fatal, with surgical resection as the single most effective modality for short-term palliation. We present the case of a patient in whom pulmonary artery sarcoma was diagnosed preoperatively and who underwent surgical resection with no evidence of recurrence during long-term follow-up, suggesting that early identification and aggressive surgical intervention has the potential to be curative.     

弥漫性泛细支气管炎的诊断:18例分析

目的 探讨弥漫性泛细支气管炎(diffuse panbronchiolitis,DPB)的临床特点、影像学表现、诊断和鉴别诊断.方法 对在北京协和医院诊断为DPB的18例患者进行回顾分析.结果 病理确诊10例,临床诊断14例.18例均以慢性咳嗽、咳痰及活动气促为主诉.14例有肺部哕音.15例有鼻窦炎.肺功能以阻塞性通气功能障碍为主.本组病例冷凝集试验阳性率低.所有胸部影像见弥漫小结节影,大部分伴支气管扩张;影像学分型和临床严重程度无明确相关性.初诊误诊率100%.结论 本组DPB患者有典型临床表现,但某些临床特点有别于日本患者.DPB影像学有特征性表现.DPB误诊率高,应提高对其认识.     

Pathologie pulmonaler Beteiligung bei Vaskulitiden und Systemerkrankungen

Manifestations of pulmonary vasculitis syndromes and collagen vascular diseases are extremely variable and diagnostically challenging. Pulmonary involvement is frequent in the primary systemic vasculitis (PSV) syndromes Wegener??s granulomatosis, Churg-Strauss syndrome and microscopic polyangiitis. PSV have to be discriminated from pulmonary involvement in other rheumatic diseases, secondary vasculitis due to infections and vascular affections secondary to lymphoproliferative diseases. Pulmonary involvement occurs in all types of collagen vascular diseases, and morphology may be identical in different types of rheumatic diseases as well as idiopathic interstitial lung disease. The diagnostic challenge here is to discriminate collagen vascular disease from idiopathic lung disease, from adverse drug effects and infections. In many cases, not all diagnostic criteria can be found in a single biopsy; therefore, the selection of appropriate biopsy material as well as a correlation with clinical, serological and radiological parameters is essential.     

18F-fluorodeoxyglucose positron emission tomography as a noninvasive method for the diagnosis of primary pulmonary artery sarcoma

Pulmonary artery sarcomas are rare, difficult-to-diagnose tumors that frequently mimic chronic pulmonary thromboembolism. We report the cases of two female patients with clinical signs of dyspnea and lung masses associated with pulmonary artery filling defects on chest CT angiography. We performed 18F-fluorodeoxyglucose positron emission tomography, which revealed increased radiotracer uptake in those lesions. Pulmonary artery sarcoma was subsequently confirmed by anatomopathological examination. We emphasize the importance of this type of tomography as a noninvasive method for the diagnosis of these tumors.     

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??Abstract??Pulmonary Infiltrates with eosinophilia??clinically referred to as eosinophilic lung diseases (ELD)??are a heterogeneous group of disorders characterized by pulmonary infiltration associated with alveolar eosinophilia with or without peripheral eosinophilia.They are classified generally as primary ELD??secondary ELD??and other diseases occasionally associated with eosinophils.Clinical manifestation of these disorders can be varied??and their presentation can be mild or fatal.Accurate diagnosis is based on a full history and examination??along with clinical manifestations??radiological imaging and laboratory findings.Corticosteroids are the mainstay of treatment for ELD and most patients will require prolonged courses of daily steroids.The dose and use duration of corticosteroids should be individualized.     

Pulmonary actinomycosis.

Pulmonary actinomycosis is a rare but important and challenging diagnosis to make. Even when the clinical suspicion is high, the disease is commonly confused with other chronic suppurative lung diseases and with malignancy. An early, accurate diagnosis will prevent the considerable psychological and physical morbidity, including unwarranted surgery, associated with delayed diagnosis. The clinical, radiological and therapeutic characteristics of the infection are reviewed here. Respiratory physicians should be aware of this important differential when investigating patients for persistent pulmonary shadowing. This will expedite the diagnosis of an otherwise highly treatable condition with an excellent prognosis if picked up early.     

肺母细胞瘤1例并文献复习

目的提高对肺母细胞瘤的认识。方法结合1例肺母细胞瘤患者的临床资料和文献复习,详细分析该病的组织起源、临床病理特点、分类、诊断、鉴别诊断、治疗及预后等。结果该病临床症状少且轻微,影像学提示“良性肿瘤”;病理学检查主要特征是镜下瘤组织由胎儿型腺管样的上皮成分和原始的肉瘤样间质成分混杂存在。免疫组化示瘤组织由上皮和间叶两种成分构成。目前尚无有效治疗措施,预后差。结论肺母细胞瘤罕见,极易误诊,应予重视。