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[目的 ]探讨支气管内膜结核的临床特征 ,误诊为肺癌的原因以及确诊的手段。 [方法 ]回顾性地分析误诊的 1 5例临床表现 ,胸部 X线 (CT) ,纤支镜检查 ,活检、刷检结果。 [结果 ]1 5例的临床表现 ,胸部 X线(CT)征象 ,纤支镜下所见均酷似支气管肺癌 ,在第一次经纤支镜活检、刷检未取得阳性结果情况下 ,将其误诊为肺癌。 7例经手术切除病理证实 ,另 8例经 2～ 3次纤支镜取活检或刷检得阳性结果证实。[结论 ]误诊原因是支气管内膜结核缺乏特征性表现 ,临床医生对其重视不足 ,X线及 CT征象酷似肺癌 ,纤支镜检查未注意观察分析两者不同之处 ,活检取材太小太浅 ,均为增殖和瘢痕病变 ,痰菌阴性 ,给医生误导。确诊主要依靠纤支镜检 ,并取活检、刷检和支气管肺泡灌洗液联合检查 ,必要时作手术切除证实
[Objective] To explore the clinical features of bronchial endometrial tuberculosis, the causes of misdiagnosis as lung cancer and the means of diagnosis. [Methods] The clinical manifestations, chest X-ray (CT), bronchofibroscopy, biopsy and brush test results were retrospectively analyzed. [Results] The clinical manifestations, chest X-ray (CT) signs and bronchogenic carcinoma in 15 cases were similar to those in bronchogenic carcinoma. After the first biopsy with fiberoptic bronchoscopy, no positive results were obtained Misdiagnosed as lung cancer. Seven cases were confirmed by surgical resection and the other eight cases were confirmed by biopsy or brush biopsy after 2 ~ 3 times. [Conclusion] The reason of misdiagnosis is the lack of characteristic manifestations of endobronchial tuberculosis. Clinicians pay little attention to it. X-ray and CT findings resemble those of lung cancer. Fiberoptic bronchoscopy does not pay attention to observation and analysis of the difference between the two. , Are proliferative and scar lesions, sputum negative, to the doctor misleading. Confirmed mainly rely on microscopic examination, and take biopsy, brush examination and bronchoalveolar lavage fluid joint examination, if necessary, for surgical resection confirmed