摘要目的 提高对原发性甲状旁腺功能亢进症伴转移性肺钙化的临床表现、胸部影像学表现、病理组织学及锝-亚甲基二膦酸盐(99mTc-MDP)骨闪烁显像表现的认识.方法 对1例诊断为原发性甲状旁腺功能亢进伴转移性肺钙化的患者的临床表现、影像学、病理及99mTc-MDP骨闪烁显像资料,结合有关文献进行回顾性分析.结果 患者女,56岁.首诊的临床表现为咳嗽和活动后气喘,影像学表现为双肺多发斑片影伴左肺及心室壁钙化影,支气管镜肺活检可见肺泡腔和肺泡间隔内多量钙化物沉积,99mTc-MDP骨闪烁显像示双侧肺野骨外显像(肺内多发钙化,类似骨骼成分,所以显像).经手术切除病变甲状旁腺后,临床症状缓解,胸部影像吸收好转.结论 以呼吸道症状为主要表现的甲状旁腺功能亢进症临床上容易误诊为肺部本身疾病,99mTc-MDP骨闪烁显像有助于区分转移性肺钙化和其他有类似临床及影像学表现的肺部疾病,从而选择正确的治疗方法.

abstractsObjective To highlight the characteristics of metastatic pulmonary calcification (MPC)of a patient with primary hyperparathyroidism.Methods The clinical,radiological,pathological and 99mTc-MDP bone scanning data of the patient with primary hyperparathyroidism were studied and relevant literature was reviewed.Results This 56 year-old female patient presented with cough and shortness of breath.The chest CT scan showed multiple,bilateral infiltrates and calcification in the left lung and ventricular wall.Transbronchial lung biopsy was performed,and the pathological study showed that there was diffuse calcification in the alveoli and alveolar septa.99mTc-MDP bone-scanning showed pulmonary uptake mostly.The patient showed significant clinical and radiological improvement after surgical removal of the parathyroid gland.Conclusions Patients of primary hyperparathyroidism with respiratory symptoms were easily misdiagnosed as primary pulmonary diseases.99mTc-MDP bone-scanning can be used to help differentiate MPC from other diseases with similar clinical and radiological findings,thus allowing prompt therapy.