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本文报告近年来我组在胸外科常规活检中的矽肺13例,手术前临床诊断为“肺癌”或“结核”。术后病理检验证实3例均有不同程期的矽肺病变,其中仅3例同时存在肺癌,仅2例有陈旧结核。13例中有4例病理也误诊为“结核”或“癌瘤”。分析误诊原因,主要在于有关医务人员缺乏职业性尘肺病的概念;其次,矽肺的临床x线表现有时可不典型且复杂多样。作者强调注意询问患者职业史和在鉴别诊断中考虑矽肺的必要性。
This article reports 13 cases of silicosis in our thoracic routine biopsy in recent years. The clinical diagnosis was “lung cancer” or “tuberculosis” before surgery. Postoperative pathological examination confirmed three cases had different stages of silicosis, of which only 3 cases of lung cancer, only 2 cases of old tuberculosis. Four of the 13 cases were misdiagnosed as “tuberculosis” or “cancer”. Analysis of the causes of misdiagnosis mainly lies in the lack of the concept of occupational pneumoconiosis among medical staffs. Secondly, the clinical manifestations of silicosis may be sometimes atypical and complicated. The authors emphasize the need to ask the patient’s occupational history and to consider silicosis in differential diagnosis.