摘要
目的探讨荚膜组织胞浆菌性孤立性肺结节(HCSPN)的临床特点。方法回顾分析本院诊断5例及国内文献报道13例经手术病理证实的HCSPN的临床资料,包括临床表现、诊断、治疗及预后等。结果18例患者中,男女之比13∶5;14例为体检时意外发现;胸部CT均表现为孤立性肺结节,下叶多于上叶(12∶6)、右肺多于左肺(11∶7);18例均误诊,初诊为肺癌15例、肺结核瘤3例,后均经外科手术、病理确诊;5例术前纤维支气管镜检查均阴性;4例于术后接受了短程的抗真菌治疗;术后随访均无复发。结论HCSPN发病男性多于女性;临床多无症状;影像学和纤维支气管镜的诊断价值不大;临床误诊率高;手术及组织病理学方法是确诊的主要手段;无需采取抗真菌治疗;预后良好。
Objective To explore the clinical features of solitary pulmonary nodule caused by histoplasma capsulatum var. capsulatum infection （HCSPN）. Methods The data （such as clinical manifestation, diagnosis, treatment and prognosis） of 18 patients of pulmonary histoplasmosis-5 from our hospital,13 from the literature written in Chinese-showing solitary pulmonary nodular shadow which were confirmed by operation and histopathology were analyzed retrospectively. Results Ratio of male to female patients was 13 ： 5. And 14 patients showed abnormal shadow on chest X-ray films during a routine check up. All of the patients had solitary pulmonary nodular on chest computed tomographic scans. Lower lobe occurred more often than upper lobe,and right lung occurred more often than left. 15 patients were misdiagnosed as lung cancer and 3 ones were tuberculoma before surgical therapy. 5 of all the patients received fiberoptic bronchoscopy check but the results were negative. 4 patients received short-term antifungal therapy after operation. No recurrence was found in the follow-up visit. Conclusion Male patients are more than female of HCSPN. Most of the patients are asymptomatic. Chest X-ray scanning and fiberoptic bronchoscopy checking have little value for diagnosis. The misdiagnosis rate is high. Operation and histopathology are the main methods of diagnosis. Antifungal therapy is unnecessary. The prognosis of HCSPN is eusemia.
出处
《临床荟萃》
CAS
2010年第10期836-838,共3页
Clinical Focus
关键词
组织胞浆菌属
硬币病变
肺
感染
回顾性研究
histoplasma
coin lesion, pulmonary
infection
retrospective studies
作者简介
通信作者：季成，Email：jijimama@sina．com
