贵州医科大学学报

2016, v.41;No.189(06) 732-734

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以纵膈淋巴结肿大为主要表现的结核病误诊原因分析
Analysis of the Causes of Misdiagnosis of Tuberculosis with Mediastinal Lymph Node Enlargement

张廷梅;
ZHANG Tingmei;Guiyang Municipal Public Health Center & Guiyang Pulmonary Hospital;

摘要(Abstract):

目的:分析纵膈淋巴结结核的误诊原因。方法:收集19例纵膈淋巴误诊病例结核的影像学、实验室及支气管镜检查资料,分析其误诊的原因。结果:19例患者肺CT扫描均显示为纵膈及肺门单个或多个肿大淋巴结,多数融合成团块状并与周围组织粘连;15例增强扫描显示淋巴结呈边缘环形强化;伴颈淋巴结肿大2例,HIV感染1例;临床误诊为恶性肿瘤9例,结节病4例,淋巴瘤6例;通过CT引导下病灶穿刺,外科手术等方法可获确诊。结论:CT增强扫描及CT引导下经皮病灶穿刺活检均能有效提高纵隔淋巴结结核诊断的阳性率。
Objective: To investigate the causes of misdiagnosis of tuberculosis of mediastinal lymph node. Methods: Imaging,laboratory,and bronchoscopy data of 19 cases of misdiagnosis of tuberculosis with mediastinal lymph node enlargement were collected and the causes of misdiagnosis were analyzed. Results: The lung CT scans of 19 cases showed that all patients suffered from single or multiple enlarged lymph nodes of the diaphragm and the hilus of lung,with most of lymph nodes fusing into mass and adhering to the surrounding tissue. The enhancement scanning of 15 cases showed the lymph nodes took on marginal ring enhancement. There were 2 cases of cervical lymph node enlargement and1 case of HIV infection. There were 9 cases of clinically misdiagnosed malignancy,4 cases of sarcoidosis and 6 cases of lymphadenoma,all of which were confirmed by CT contrast enhanced scan and CT guided percutaneous puncture biopsy,surgery and other methods. Conclusion: CT contrast enhanced scan and CT guided percutaneous puncture biopsy can effectively improve the positive rate of diagnosis of tuberculosis of mediastinal lymph node.

关键词(KeyWords): 结核,淋巴结;纵膈;误诊;诊断;体层摄影术,X线
tuberculosis;lymph node;mediastinum;misdiagnosis;diagnosis;tomography;X-ray

Abstract:

Keywords:

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作者(Author): 张廷梅;
ZHANG Tingmei;Guiyang Municipal Public Health Center & Guiyang Pulmonary Hospital;

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DOI: 10.19367/j.cnki.1000-2707.2016.06.026

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