Misdiagnosis Analysis And Literature Review Of Primary Pulmonary

Objective:Investigating the clinical characteristics,misdiagnosis reasons and preventive measures of primary pulmonary lymphoma(PPL).Methods:The clinical data of 12 cases of primary pulmonary lymphoma,which had been misdiagnosed in the First Affiliated Hospital of Chongqing Medical University,were studied.The causes of misdiagnosis were analyzed with the review of the literature.Results:Among the 12 patients,10 manifested respiratory symptoms including cough in 8 patients,expectoration in 6 patients,chest pain and chest tightness each in 3 patients,one of these patients experienced fever.Two cases were found by physical examination because of asymptomatic symptoms.Chest computed tomography showed 9 cases of nodular mass,2 cases of solid type,which air bronchogram can be seen,and 1 case had multiple nodules,some cases can combine with pleural effusion.6 cases were confirmed by surgical lung biopsy,3 cases were diagnosed by bronchoscopic lung biopsy,2 cases were diagnosed by CT-guided percutaneous lung biopsy,and 1 case was confirmed by biopsy of chest wall tumor.All 12 patients were confirmed by pathologically,ten of these do the immunohistochemistry at the same time.12 cases were misdiagnosed,the shortest misdiagnosis time is 1 month and the longest is 7 years,the average time is about 9 months.Conclusion:PPL mostly has cough,sputum,and chest pain as the first symptoms,and some of them may be asymptomatic asymptomatic finding by physical examination.Radiographic manifestations varied,the most common type of nodular mass.Surgical lung biopsy is the main method of get the organization to diagnosis,next are bronchoscopic lung biopsy and CT-guided percutaneous lung biopsy,only a few patients confirmed by other methods.Improve the understanding of the disease,choose the appropriate method,and early access to sufficient histopathological specimens,combine with clinical and immunohistochemical to make a diagnosis earlier can reduce misdiagnosis.