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目的报告以脊髓病变为首发表现的小细胞肺癌(small cell lung cancer,SCLC)1例,结合文献探讨其流行病学、病理学、临床表现、诊断及治疗现状。方法报告1例SCLC临床特点及胸部CT、脊髓MRI、支气管镜刷片病理等相关检查结果。结果临床表现为突发腰部、双下肢疼痛2个月。胸部CT增强扫描发现右肺上叶肿块影,右肺门及纵隔淋巴结肿大,T11占位,胸椎MRIT10水平椎管继发性狭窄,胸髓受压伴水肿。支气管镜右肺上叶尖后段支气管活检、刷片病理确诊为小细胞癌。结论以脊髓病变为首发表现的SCLC少有报道,胸部CT、支气管镜结合支气管肺活检、刷片、痰脱落细胞学、经皮肺穿刺活检等可明确诊断。目前,SCLC的最佳治疗策略是化疗、放疗、手术等综合治疗模式。
Objective To report 1 case of small cell lung cancer (SCLC) with myelopathy as the first manifestation and to discuss its epidemiology, pathology, clinical manifestation, diagnosis and treatment status with literature. Methods One case of SCLC clinical features and chest CT, spinal cord MRI, bronchoscopy brush pathology and other related test results. Results The clinical manifestations of sudden waist, lower extremity pain for 2 months. Chest CT enhancement scan found the right upper lobe mass, right hilar and mediastinal lymph nodes, T11 occupancy, thoracic MRIT10 secondary spinal stenosis, compression of the chest with edema. Bronchoscopy right posterior segment of the upper lungs bronchial biopsy, brush pathology diagnosed as small cell carcinoma. Conclusion There are few reports of SCLC with myelopathy as the first manifestation. Chest CT, bronchoscopy combined with bronchopulmonary biopsy, brush smear, sputum exfoliative cytology and percutaneous lung biopsy can confirm the diagnosis. At present, the best treatment strategy of SCLC is the comprehensive treatment mode of chemotherapy, radiotherapy and surgery.