The differential diagnosis of lung cancer

By | October 10, 2011

Differential diagnosis of lung cancer cases according to tumor location, pathological type and duration of morning and evening so different situations presented in the clinical symptoms and X-ray findings are also diverse, easily confused with other lung diseases. Thus, early cases of lung cancer in particular, the differential diagnosis of early diagnosis and early treatment is important.
The differential diagnosis of lung cancer (a) TB
1. Tuberculoma easy to be confused with peripheral lung cancer. Tuberculoma more common in young patients. Lesion is usually located on the tip, the dorsal posterior segment or the next paragraph, the general growth is not obvious, longer course, on the block in the X-ray film density is uneven, sparse transmission region can be seen, often calcification, smooth edges, boundaries clear, while often sporadic pulmonary tuberculosis.
2. Miliary tuberculosis with diffuse X-ray findings of bronchioloalveolar carcinoma similar. Miliary tuberculosis is common in young, fever, night sweats and other symptoms of systemic toxicity, anti-TB drug treatment can improve symptoms, the lesions gradually absorbed.
3. Hilar lymph node tuberculosis in the X-ray films of the hilar shadow may be mistaken for the central block of lung cancer. Hilar lymph node tuberculosis more common in young childhood, often symptoms of TB infection, there is little hemoptysis, positive tuberculin skin test often, effective anti-tuberculosis drug treatment.
It is noteworthy that a small number of patients with pulmonary tuberculosis with lung cancer exists, because no special clinical performance, X-ray findings and easily overlooked, clinicians often easy to be satisfied with the diagnosis of pulmonary tuberculosis at the same time ignore the existence of cancer lesions, which often delayed lung early diagnosis. Therefore, middle-aged pulmonary tuberculosis patients, tuberculosis or other lung field lesion sites within the present massive shadow, the anti-TB drugs in treatment of lung lesions did not improve, but increase or block video segment or lobe associated with pulmonary atelectasis, widening of the hilar shadow side of such situations, should lead to the coexistence of tuberculosis and lung cancer was highly suspected, further for sputum cytology and bronchoscopy and so on.
The differential diagnosis of lung cancer (II), pulmonary inflammation
1. Bronchial pneumonia resulting in early obstructive lung misdiagnosed as pneumonia and bronchial pneumonia. Generally more acute onset of bronchial pneumonia, fever, chills and other more obvious signs of infection, the antibiotic therapy the symptoms quickly disappeared after the lung disease is also rapidly absorbed. If absorption is slow or recurring inflammation, should be further in-depth examination.
2. Liquefaction necrosis of lung abscess formation of the central part of lung cancer when empty, X-ray findings easily confused with lung abscess. Cases of lung abscess is often a history of aspiration pneumonia. Obvious acute signs of infection, sputum volume, was purulent, with the smell. X-ray film over the wall thin, smooth wall, a liquid surface, the surrounding lung abscess or pleural inflammation often. Bronchial angiography contrast agent can enter the hole more, and often accompanied by bronchiectasis.
The differential diagnosis of lung cancer (c) other breast cancer
1. Lung benign tumor benign tumor of the lung sometimes be differentiated from the surrounding lung cancer. Benign lung generally does not show clinical symptoms, slow growth, long course. Displayed on the X-ray film near the circular block, may have calcification, contour neat, clear boundary, and more non-lobulated.
2. Solitary metastatic lung cancer, solitary pulmonary metastasis and primary peripheral lung cancer is difficult to distinguish. Differential diagnosis mainly depends on detailed history and primary signs and symptoms of cancer. Metastatic carcinoma of the lung showing respiratory symptoms are usually less blood and sputum, sputum cytology is not easy to find cancer cells.
3. Mediastinal tumor with central lung cancer and mediastinal tumor may sometimes be confused. Diagnostic artificial pneumothorax help to clear the site of the tumor is located. Mediastinal tumor had less hemoptysis, sputum cytology failed to find cancer cells. Bronchoscopy and bronchography contribute to the differential diagnosis. Mediastinal lymphoma found in young patients more often had bilateral disease, may have fever and other symptoms.

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