Difficulty in the differential diagnosis of peritoneal carcinomatosis and tuberculosis in a young female patient with ascites: a case report

Tamara S. Nefedova; Нефедова Тамара Сергеевна; Tamara S. Nefedova; Yuliya F. Shumskaya; Шумская Юлия Федоровна; Yuliya F. Shumskaya; Marta V. Yurazh; Юраж Марта Валерьевна; Marta V. Yurazh; Alexandr S. Panferov; Панферов Александр Сергеевич; Alexandr S. Panferov; Pavel V. Senchikhin; Сенчихин Павел Владимирович; Pavel V. Senchikhin; Alexei E. Grabarnik; Грабарник Алексей Ефимович; Alexei E. Grabarnik; Igor O. Shchekoturov; Щекотуров Игорь Олегович; Igor O. Shchekoturov; Marina G. Mnatsakanyan; Мнацаканян Марина Генриковна; Marina G. Mnatsakanyan

doi:10.17816/DD568134

一名年轻腹水患者腹膜转移癌和腹部结核的鉴别诊断难题：病例介绍

作者: Nefedova T.S.¹, Shumskaya Y.F.², Yurazh M.V.¹, Panferov A.S.¹, Senchikhin P.V.¹^,3, Grabarnik A.E.⁴, Shchekoturov I.O.¹, Mnatsakanyan M.G.¹
隶属关系:
1. The First Sechenov Moscow State Medical University
2. Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies
3. National Medical Research Center for Phthisiopulmonology and Infectious Diseases
4. Moscow Scientific and Clinical Center for Tuberculosis Control
期: 卷 4, 编号 4 (2023)
页面: 643-652
栏目: 临床病例及临床病例的系列
URL: https://journals.rcsi.science/DD/article/view/262992
DOI: https://doi.org/10.17816/DD568134
ID: 262992

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详细

腹部结核和腹膜转移癌的鉴别诊断难点在于临床表现、实验室和仪器检查方法的数据的相似性。腹腔结核和腹膜转移癌都可能伴有腹水、淋巴聚集体和肠襻的形成。

文章描述了对一名年轻患者的临床观察。第二次分娩后，患者发现了肩胛骨之间的颈部出现剧烈疼痛。随后，在出现症状两个月后，患者患上了肺炎，并对抗生素治疗产生了积极反应。两个月后，她首次发现了反复腹水和胃肠道症状。检查发现了卵巢病变、腹膜转移癌征候以及肺部病灶。然而，腹膜转移癌的临床表现并不典型，而且肺部有特殊病变，因此怀疑是多部位结核。通过腹腔镜检查和受影响组织的活检，以及随后的组织学和实验室检查，确诊为Mycobacterium tuberculosis。

该病例表明，在确定年轻女性患者腹水的病因时，必须使用所有可用的诊断方法，以便对特异性病因和肿瘤性病因进行鉴别诊断。

关键词

多部位结核, 腹部结核, 腹腔结核, 腹膜转移癌, 腹水, 病例介绍

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MD, Cand. Sci. (Med.), Assistant Professor

俄罗斯联邦, Moscow

Pavel V. Senchikhin

The First Sechenov Moscow State Medical University; National Medical Research Center for Phthisiopulmonology and Infectious Diseases

Email: paulus200271@mail.ru
ORCID iD: 0000-0003-0496-4504
SPIN 代码: 8293-6144

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow; Moscow

Alexei E. Grabarnik

Moscow Scientific and Clinical Center for Tuberculosis Control

Email: a.grabarnik@mail.ru
ORCID iD: 0009-0009-4885-3321
SPIN 代码: 5923-8630

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow

Igor O. Shchekoturov

The First Sechenov Moscow State Medical University

Email: samaramail@bk.ru
ORCID iD: 0000-0002-2167-8908
SPIN 代码: 6885-6834

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow

Marina G. Mnatsakanyan

The First Sechenov Moscow State Medical University

Email: mnatsakanyan08@mail.ru
ORCID iD: 0000-0001-9337-7453
SPIN 代码: 2015-1822

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow

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