我们在工作中曾遇到4例肺泡细胞癌误诊为肺结核,现分析如下。 临床资料:4例患者均为男性,年龄42～49岁。均有不同程度咳嗽、咳痰、痰中带血、胸闷憋气、胸痛、发热等症状,病史1～5个月。初诊为肺结核,抗痨治疗1～3个月无效。胸片示:两肺弥漫分布密度较高的小结节状阴影,以中下肺野为著,其中1例伴有肺门肿块,2例伴有胸腔积液,经颈部淋巴结活检、纤支镜检查、痰细胞学检查及胸水细胞学检查均确诊为肺泡细胞癌。 误诊原因分析:①本病早期症状不典型,甚至无症状,只是在体检中偶然发现。X线表现均呈不同程度弥漫性结节样病灶、弥漫性浸润样病灶及粟 We have encountered four cases of alveolar cell carcinoma misdiagnosed as tuberculosis in our work. The analysis is as follows. Clinical data: All 4 patients were male and were 42 to 49 years old. All have varying degrees of cough, sputum, bloody sputum, chest tightness, sputum, chest pain, fever and other symptoms, history of 1 to 5 months. The first diagnosis was tuberculosis, and the antituberculosis treatment was invalid for 1 to 3 months. The chest radiograph showed: small nodular shadows with high diffuse density in both lungs, with middle and lower lung fields as the primary, 1 with hilar mass, 2 with pleural effusion, and cervical lymph node biopsy, fiber Bronchoscopy, sputum cytology, and pleural fluid cytology were all diagnosed as alveolar cell carcinoma. Misdiagnosis causes analysis: 1 The early symptoms of the disease are not typical, even asymptomatic, but were found by chance during physical examination. X-ray findings showed diffuse nodules-like lesions, diffuse infiltrated lesions, and millet