- 期刊
Cytodiagnosis of Sputum from a Patient with Lung Parenchymal Involvement of Hodgkin's Lymphoma: A Case Report and Literature Review
痰液的細胞學診斷應用於何杰金氏淋巴瘤肺實質侵犯：病例報告及文獻回顧
摘要
何杰金氏淋巴瘤侵犯肺實質一般較少見，胸部X光表現可為單一或多發性肺部結節病灶合併縱隔腔及肺門淋巴結，需與原發或轉移性肺部腫瘤作鑑別診斷。痰液細胞學檢查中發現典型的Reed-Sternberg氏細胞實屬罕見，但可以提供何杰金氏淋巴瘤肺實質侵犯的診斷初步證據。我們報告一位52歲的女性病患，因為乾咳、胸部不適以及體重減輕而就診。胸部影像學檢查懷疑為原發或轉移性肺部腫瘤。然而淋巴瘤肺部侵犯的可能性亦須考慮。細胞學檢查中所發現典型的Reed-Sternberg氏細胞，可能被忽略或是被誤認為肺癌。藉著高度懷疑與良好的確認，痰液細胞學檢查可提供我們一個重要的線索解答這個難題並且進一步尋求病理切片已得到正確診斷。
並列摘要
Involvement of the lung parenchyma at the time of initial diagnosis is relatively rare in Hodgkin's lymphoma (HL). The radiographic appearance may be either solitary or multiple nodules with or without concomitant hilar and mediastinal lymphadenopathies. Differential diagnosis may include primary or metastatic cancer of the lung. The reliability of the cytologic diagnosis of HL has been demonstrated by common cytologic methods. Infrequently, Reed-Sternberg (RS) cells identified in sputum cytology were able to provide the initial diagnostic basis for HL with lung involvement. We reported herein a 52-year-old woman with the initial presentation of nonproductive cough, chest discomfort, and body weight loss. Primary or metastatic cancer of the lung was suspected from the image studies of the chest. However, the possibility of lymphoma with lung involvement should be considered. Cytology methods revealed characteristic RS cells, which could have been overlooked and mistaken as primary lung cancer initially. With a high index of suspicion and improved recognition, sputum cytology provided us an important clue to resolve this dilemma and pursue a confirmatory pathologic diagnosis.
延伸閱讀
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