关键词: 腺癌, 细支气管肺泡, 结核, 肺, 误诊

Abstract: Objective  To study the clinical characteristic, the causes of misdiagnosis, diagnosis and treatment experience of bronchioloalveolar carcinoma. Methods From 2009 January to 2012 January, 203 cases who were initially misdiagnosed as pulmonary tuberculosis were diagnosed finally with other lung diseases among 22047 cases diagnosed with pulmonary tuberculosis in Xi’an Tuberculosis and Thoracic Tumor Hospital. Forty-two cases were confirmed as bronchioloalveolar carcinoma among 203 cases. A retrospective clinicopathologic analysis was conducted on these 42 patients. Results The typical clinical manifestations of bronchioloalveolar carcinoma were cough and expectoration, shortness of breath, chest pain and stuffinees. All patients were divided into 3 categorie accor-ding to imaging finding. Solitary nodular type 33 cases, pneumonia type 4 cases and diffuse nodular type 5 cases. Forty-two patients with bronchioloalveolar carcinoma were misdiagnosed as pulmonary tuberculosis, of which 23 were misdiagnosed as infiltrative pulmonary tuberculosis, pulmonary tuberculoma in 11 cases, 5 cases of subacute blood disseminated pulmonary tuberculosis and 3 cases of pulmonary tuberculosis complicated with serous cavity effusion. Symptoms were repeated and imaging were unimproved after anti-tuberculosis therapy. All cased were diagnosed finally with bronchioloalveolar carcinoma by pathological examination.  Conclusion The clinical symptom and imaging manifestations of bronchioloalveolar carcinoma have its low specificity which is easily misdiagnosed as pulmonary tuberculosis. It should be comprehensive analysis to enhance the rate of early diagnosis.

Key words: Adenocarcinoma, bronchiolo-alveolar, Tuberculosis, pulmonary, Diagnostic errors