I once received a 25-year-old girl on the Internet, a single mother, and the child is only two years old. In a unit physical examination, her chest CT showed a 2 cm solid nodule in her upper left lung with a lobe burr, which looked more like a malignant tumor in terms of morphology. Of course, she also consulted many other experts in the industry, including oncology, thoracic surgery, respiratory medicine, and the vast majority of experts believe that malignant tumors are likely. Looking at the young child, this result made her feel that the sky was about to fall. Arranging the child, this strong young mother went to the operation alone for the first time, and a week later the surgery came out of the big pathology, which was a tuberculosis ball. Seeing the pathology report, she wept with joy and had a feeling of rebirth.
Many people who do not know will have such a thought, is tuberculosis not easy to diagnose, how can it be misdiagnosed as lung cancer? In fact, patients are not textbook-based, and many patients have clinical manifestations that are far from typical cases. A thoracic surgery expert in the industry said that the preoperative thought that lung cancer was possible, and it was also lung cancer, and this proportion could reach more than 90%, then this hospital was already quite powerful. No matter how clear the imaging examination is, no matter how high the resolution, it is only a way to take pictures. Whether the clumps contain tuberculosis bacteria or cancer cells can only be determined under a microscope.
Why is it possible that a tuberculosis bulb can be misdiagnosed as lung cancer?
1. Clinical symptoms are similar
Lung cancer and tuberculosis in the clinic will have cough, sputum or cough with blood, fatigue, body wasting and other symptoms, a small number of people also have low-grade fever.
There are similarities in imaging
Tuberculosis bulbs are a proliferative foci formed by tuberculosis that has not been completely cured, and some patients who undergo enhanced CT can also be partially strengthened, which is very similar to the performance of lung cancer in enhanced CT. If the bulbs are not calcified, hollow, or satellite, but only marginally hairy and shallow lobes, it is likely to be misdiagnosed as lung cancer.
If the tuberculosis bulb is treated as lung cancer, is it considered a medical accident?
When a nodule or mass appears in the lungs, we generally recommend that the patient have a bronchoscopy or lung puncture to make a definitive pathological diagnosis. Although there is a small probability that the diseased tissue may not be obtained, one more examination will provide more protection for a clear diagnosis. For direct surgery with high suspicion of lung cancer before surgery, it was found to be a tuberculous ball, and the incidence of this situation is still relatively low. Even if it does, it is not medical malpractice. First of all, relying solely on imaging tests cannot be 100% certain that it must be malignant, and the preoperative doctor will inevitably explain clearly, even if the probability of one in 100,000 is not malignant. Secondly, the tuberculosis ball is a fibrous connective tissue wrapped in a cheese-like lesion, which contains live tuberculosis bacteria, and it is generally difficult to enter the antibacterial drugs, so for tuberculosis balls above 2cm, sometimes surgery can be considered, and the postoperative regular antituberculosis treatment is half a year, which can be once and for all to prevent tuberculosis from recurring caused by tuberculosis.
Frankly speaking, it is better to diagnose tuberculosis as lung cancer than to misdiagnose lung cancer as tuberculosis, because if you obviously have lung cancer, but you have always treated tuberculosis, it will inevitably delay the best time to treat lung cancer. In addition, when immunity is low, lung cancer may occur with active tuberculosis, and it is also important to be careful.