论文部分内容阅读
目的探讨木村病的诊断误区。方法报道解放军总医院2010年收治的伴纵隔淋巴结肿大的木村病1例。在PubMed以及万方、维普等数据库搜索相关文献,查及木村病伴纵隔淋巴结肿大的病例3例。分析包括本例在内的4例患者的临床资料,总结近年来关于木村病的诊断及治疗方面的最新进展。结果本例患者为61岁男性,最初于2008年诊断为肺癌,但组织病理学检查未见癌细胞,纵隔淋巴结内仅见嗜酸性粒细胞浸润。2010年患者因双侧眼眶肿物就诊,手术病理证实为嗜酸性粒细胞肉芽肿,即木村病。复习文献并加上本例在内,共获得4例合并纵隔淋巴结肿大的木村病患者的临床资料。其中2例误诊为肺癌,2例误诊为淋巴瘤。激素治疗对全部4例患者均有效。结论木村病伴纵隔淋巴结肿大病例极其罕见,临床上易误诊。微创纵隔穿刺活检技术,如超声内镜和超声内镜引导下的经支气管针吸活检对鉴别诊断有帮助。
Objective To explore the diagnostic errors of Kimura disease. Methods Reported by PLA General Hospital in 2010, 1 case of Kimura disease with enlarged mediastinal lymph nodes. In PubMed and Wanfang, Vip and other databases to search for relevant literature, check the case of Kimura disease with mediastinal lymph nodes in 3 cases. The clinical data of 4 patients including this case were analyzed and the latest progress in the diagnosis and treatment of Kimura disease in recent years was summarized. Results The patient was 61 years old and was initially diagnosed with lung cancer in 2008, but no histopathological examination of cancer cells was found. Only eosinophil infiltration was found in mediastinal lymph nodes. 2010 patients with bilateral orbital tumor treatment, surgical pathology confirmed as eosinophilic granuloma, Kimura disease. Review the literature and add this case, including a total of 4 cases of patients with clinical manifestations of mediastinal lymph node enlargement of Kimura disease. Two of them were misdiagnosed as lung cancer and two were misdiagnosed as lymphoma. Hormone therapy was effective in all 4 patients. Conclusion Kimura disease with mediastinal lymph node enlargement cases are extremely rare, clinically misdiagnosed. Minimally invasive mediastinal biopsy techniques, such as endoscopic ultrasonography and endoscopic ultrasonography guided bronchial needle aspiration biopsy can be helpful in differential diagnosis.