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目的:分析2例血液系统恶性胸腔积液误诊为结核性胸膜炎病例的临床表现、胸水常规生化病理特点及诊治经过等,提高对良恶性胸腔积液的诊断及鉴别能力。方法:回顾性分析自2012年01月~2014年12月入住我国西北部结核病高发区某基层三甲医院2例血液系统恶性肿瘤的临床资料,在治疗期间曾被误诊为结核性胸膜炎,结合相关文献进行分析。结果:2例血液系统恶性胸腔积液患者早期均误诊为结核性胸膜炎,最终1例确诊为单形性CD56阳性的肠道T细胞淋巴瘤,1例确诊为急性淋巴细胞白血病(L2型)。结论:胸腔积液为呼吸内科常见病,病因复杂,在缺乏有特异性检查指标的前提下早期明确诊疗较为困难。只有多种手段联合检测,结合临床才能及时、准确地作出诊断,内科胸腔镜在此作用突出。
Objective: To analyze the clinical manifestations of 2 cases of malignant pleural effusion of hematological malignancy misdiagnosed as tuberculous pleurisy, the regular biochemical and pathological features of pleural effusion and the diagnosis and treatment of benign and malignant pleural effusions to improve the ability of diagnosis and differential diagnosis of benign and malignant pleural effusions. Methods: The clinical data of 2 hematological malignancies admitted to a grassroots top three hospital in northwestern China from January 2012 to December 2014 were retrospectively analyzed. During the treatment, they were misdiagnosed as tuberculous pleurisy. Combined with related literatures Analyze. Results: Two patients with malignant pleural effusion were all misdiagnosed as tuberculous pleurisy in the early stage. One case was diagnosed as CD56 positive enteric T cell lymphoma and one case was diagnosed as acute lymphoblastic leukemia (L2 type). Conclusions: Pleural effusion is a common disease in respiratory medicine. The etiology is complicated. It is difficult to confirm the diagnosis and treatment in the absence of specific test indicators. Only a variety of means joint detection, combined with clinical ability to make timely and accurate diagnosis, medical thoracoscopy prominent role in this.