罕见的肺泡微结石症误诊一例分析

摘要

Objective To investigate clinical manifestations, misdiagnosis cause of pulmonary alveolar microliasis (PAM) and its countermeasures. Methods Retrospective analysis of clinical data of a case of PAM misdiagnosed as pulmonary tuberculosis was conducted. Results The patient was admitted for intermittent coughing, expectoration with dyspnea for 8 years, and aggravation for 3 weeks. The patient was misdiagnosed as having pulmonary tuberculosis and acute upper respiratory tract infection in other hospitals. The diagnosis of PAM, cor pulmonale, was defined after a physical examination and iatrical examination. The patient recovered and was diacharged after inhaling oxygen, anti-infection and symptomatic treatment. Conclusion An icconographic examination is very important for PAM diagnosis. A typical case can be diagnosed by iconography without biopsy. The main cause of misdiagnosis may be due to lack of understanding of PAM, limited diagnostic thinking and no access to specificity iatrical examination.%目的 探讨肺泡微结石症(pulmonary alveolar microlithiasis,PAM)的临床表现、误诊原因及其防范措施.方法 对我院近年收治的1例误诊为肺结核的PAM临床资料进行回顾性分析.结果 患者因间断咳嗽、咳痰伴胸闷8年,加重3周入院.外院诊断为肺结核及急性上呼吸道感染,予相应治疗无效,入我院.经细致查体及行相关医技检查后确诊为PAM、肺源性心脏病.予吸氧、抗感染及对症治疗后,病情好转出院.结论 影像学检查对PAM的诊断至关重要,典型病例不需活检,通过影像学检查即可诊断.缺乏对PAM认识、诊断思维局限及未行特异性医技检查是造成PAM误诊的主要原因.