- 期刊
Isolated Tuberculous Mediastinal Lymphadenopathy Mimicking a Tumor
以腫瘤表現之單一結核性縱膈腔淋巴病變：一病例報告
摘要
結核性縱膈腔淋巴病變並不常發生在免疫正常的人，且診斷上也往往是困難的。雖然以病史詢問、身體檢查、胸部X光片、痰液培養與支氣管鏡檢，我們仍常常無法診斷出結核性淋巴病變。通常這時就需要藉由手術切片、病理檢查與檢體組織培養來證實這個診斷。 在本文中，我們報告了一位以兩個月胸痛來表現的53歲家庭主婦。她因此求醫並接受胸部X光與電腦斷層檢查，意外發現了一個異常的左前縱膈腔腫瘤。這個單一的邊緣平滑之圓形腫瘤位在主動脈與肺動脈窗的旁邊，大小為5.5 x 5.0 x 2.0公分。肺部或其他器官均無異常現象。一系列的檢查都沒有辦法確認診斷，故她接受了胸腔鏡腫瘤切除手術。在病理檢查中，意外發現了有肉芽腫性炎症以及抗酸性染色陽性的結核桿菌之出現，故結核性縱膈腔淋巴病變才得以診斷確認。此病人經過12個月的抗結核菌藥物治療後，結核菌感染已完全康復。
並列摘要
A previously healthy 53-year-old woman had suffered from chest pain for 2 months, and imaging studies revealed a left mediastinal tumor. Preoperative bacteriological examinations failed to uncover evidence of tuberculous infection. However, after videoassisted thoracoscopic surgery (VATS), the tumor was proved to be tuberculous mediastinal lymphadenopathy. Our experience revealed a unique manifestation of tuberculosis which was neglected by conventional methods and required surgery to establish the diagnosis. Therefore, with the high disease burden worldwide and the various imaging presentations of tuberculosis, we should always take tuberculous mediastinal lymphadenopathy into consideration in the differential diagnosis of intrathoracic lesions.
延伸閱讀
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