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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rentrad</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник рентгенологии и радиологии</journal-title><trans-title-group xml:lang="en"><trans-title>Journal of radiology and nuclear medicine</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0042-4676</issn><issn pub-type="epub">2619-0478</issn><publisher><publisher-name>Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20862/0042-4676-2015-0-5-72-83</article-id><article-id custom-type="elpub" pub-id-type="custom">rentrad-83</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СЛУЧАЙ ИЗ ПРАКТИКИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL NOTE</subject></subj-group></article-categories><title-group><article-title>Сложный случай дифференциальной диагностики очагово-инфильтративных изменений легких во фтизиатрической практике</article-title><trans-title-group xml:lang="en"><trans-title>A difficult case of the differential diagnosis of focal infiltrative lung changes in phthisiatric practice</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Карпина</surname><given-names>Н. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Karpina</surname><given-names>N. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д. м. н., вед. науч. сотр. клинико-диагностического отдела, заведующая консультативно-поликлиническим отделением</p></bio><bio xml:lang="en"><p>MD, PhD, DSc, Leading Researcher of Clinicodiagnostic Department, Head Consultative Polyclinic Department</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Антипова</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Antipova</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к. м. н., фтизиатр</p></bio><bio xml:lang="en"><p>MD, PhD, Phthisiologist</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чеклецова</surname><given-names>Л. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Chekletsova</surname><given-names>L. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к. м. н., рентгенолог</p></bio><bio xml:lang="en"><p>MD, PhD, Radiologist</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Поссаженникова</surname><given-names>С. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Possazhennikova</surname><given-names>S. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>заведующая рентгенодиагностическим отделением</p></bio><bio xml:lang="en"><p>Head of Radiology Diagnostic Department</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Демихова</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Demikhova</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д. м. н., профессор, заместитель директора по научной работе</p></bio><bio xml:lang="en"><p>MD, PhD, DSc, Professor, Deputy Director for Science</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Центральный научно-исследовательский институт туберкулеза»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Central Research Institute of Tuberculosis</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Филиал ГКУЗ «Московский городской научно-практический центр борьбы с туберкулезом» Департамента здравоохранения г. Москвы по Зеленоградскому автономному округу</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow city Branch of the Scientific-Practical Center for Tuberculosis Control of the Health Department of the city of Moscow on Zelenograd Autonomous Okrug</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2015</year></pub-date><pub-date pub-type="epub"><day>09</day><month>03</month><year>2016</year></pub-date><volume>0</volume><issue>5</issue><fpage>36</fpage><lpage>41</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Карпина Н.Л., Антипова А.В., Чеклецова Л.И., Поссаженникова С.Ю., Демихова О.В., 2016</copyright-statement><copyright-year>2016</copyright-year><copyright-holder xml:lang="ru">Карпина Н.Л., Антипова А.В., Чеклецова Л.И., Поссаженникова С.Ю., Демихова О.В.</copyright-holder><copyright-holder xml:lang="en">Karpina N.L., Antipova A.V., Chekletsova L.I., Possazhennikova S.Y., Demikhova O.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.russianradiology.ru/jour/article/view/83">https://www.russianradiology.ru/jour/article/view/83</self-uri><abstract><p>Ошибки при дифференциальной диагностике заболеваний органов дыхания, сопровождающихся рентгенологическими изменениями легочной ткани в виде очагов и инфильтрации, возникают достаточно часто. Среди выявляемой конкурирующей патологии легких высокий процент составляют инфильтративный, диссеминированный туберкулез легких, онкозаболевания и пневмонии. Частота случаев расхождения диагноза при данных видах патологии легких превышает 30%, а период диагностики инфильтративного процесса в легких в 20% случаев длится 2–3 нед, а в 80% – более 1–3 мес. В частности, большие трудности возникают у клиницистов в диагностике аспирационной пневмонии. Это связано с тем, что при данном заболевании рентгенологические проявления не являются сугубо специфичными и характеризуются паренхиматозным (альвеолярным) типом инфильтрации легочной ткани с разным объе-мом воспаления.В данной статье представлено клиническое наблюдение пациента с аденокарциномой слюнной железы и очагово-инфильтративными изменениями в легких. Трудности диагностики возникли при установлении генеза изменений в легких.</p></abstract><trans-abstract xml:lang="en"><p>Errors occur rather commonly in the differential diagnosis of respiratory diseases accompanied by X-ray lung tissue changes as foci and infiltration. Infiltrative and disseminated pulmonary tuberculosis, lung cancer, and pneumonia constitute a high proportion among the detected concurrent lung diseases. The rate of diagnostic discordance for these lung abnormalities accounts for more than 30%; and the diagnosis period for an infiltrative lung process lasts 2–3 weeks in 20% of cases and above 1–3 months in 80%. In particular, clinicians are faced with great difficulties in diagnosing aspiration pneumonia; this is due to that its X-ray manifestations are not purely specific and they are characterized by the parenchymal (alveolar) infiltration oflung tissue with a varying extent of lung inflammation.This paper describes a clinical case of a patient with salivary gland adenocarcinomaand focal infiltrative lung changes. Diagnostic difficulties have emerged in establishing the genesis of the changes in the lung.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>дифференциальная диагностика</kwd><kwd>туберкулез легких</kwd><kwd>аспирационная пневмония</kwd><kwd>очагово- инфильтративные изменения легких</kwd></kwd-group><kwd-group xml:lang="en"><kwd>differential diagnosis</kwd><kwd>pulmonary tuberculosis</kwd><kwd>aspiration pneumonia</kwd><kwd>focal infiltrative lung changes</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Demikhova O.V., Karpina N.L. Optimization of diagnosis and differential diagnosis of disseminated pulmonary tuberculosis. Vestnik Rossiyskoy akademii meditsinskikh nauk. 2012; 11: 15–20 (in Russian).</mixed-citation><mixed-citation xml:lang="en">Demikhova O.V., Karpina N.L. Optimization of diagnosis and differential diagnosis of disseminated pulmonary tuberculosis. Vestnik Rossiyskoy akademii meditsinskikh nauk. 2012; 11: 15–20 (in Russian).</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Fedchenko G.G. Complex radiology and endoscopic diagnosis of community-acquired pneumonia. Dr. med. sci. Thesises of Diss. Moscow; 2008 (in Russian).</mixed-citation><mixed-citation xml:lang="en">Fedchenko G.G. Complex radiology and endoscopic diagnosis of community-acquired pneumonia. Dr. med. sci. Thesises of Diss. Moscow; 2008 (in Russian).</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Mamilyaev R.M. Roentgenological differential diagnosis of focal tuberculosis and peripheral lung cancer. Problemy tuberkuleza organov dykhaniya. 1998; 6: 52–3 (in Russian).</mixed-citation><mixed-citation xml:lang="en">Mamilyaev R.M. Roentgenological differential diagnosis of focal tuberculosis and peripheral lung cancer. Problemy tuberkuleza organov dykhaniya. 1998; 6: 52–3 (in Russian).</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Khomenko A.G. Tuberculosis. Handbook for doctors. Moscow: Meditsina; 1998 (in Russian).</mixed-citation><mixed-citation xml:lang="en">Khomenko A.G. Tuberculosis. Handbook for doctors. Moscow: Meditsina; 1998 (in Russian).</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Cheremisina I.A. Frequency of pathology of the lungs and the level of clinical diagnosis in Saint- Petersburg according to the findings in autopsies. PhD med. sci. Thesises of Diss. Moscow; 2000 (in Russian).</mixed-citation><mixed-citation xml:lang="en">Cheremisina I.A. Frequency of pathology of the lungs and the level of clinical diagnosis in Saint- Petersburg according to the findings in autopsies. PhD med. sci. Thesises of Diss. Moscow; 2000 (in Russian).</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Chibisov V.I., Trakhtenberg A.Kh., Pikin O.V. The mistakes in diagnosis and treatment of the malignant tumors of lungs. Terapevticheskiy arkhiv. 2004; 10: 5–12 (in Russian).</mixed-citation><mixed-citation xml:lang="en">Chibisov V.I., Trakhtenberg A.Kh., Pikin O.V. The mistakes in diagnosis and treatment of the malignant tumors of lungs. Terapevticheskiy arkhiv. 2004; 10: 5–12 (in Russian).</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Deykina O.N. Differential diagnosis of pneumonia and pulmonary tuberculosis. PhD med. sci. Thesises of Diss. Moscow; 2004 (in Russian).</mixed-citation><mixed-citation xml:lang="en">Deykina O.N. Differential diagnosis of pneumonia and pulmonary tuberculosis. PhD med. sci. Thesises of Diss. Moscow; 2004 (in Russian).</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Laushkina Zh.A., Filimonov P.N. Clinical and roentgenological peculiarities of pneumonia in patients of phthiziatrical hospital. Ftiziatriya i pul'monologiya. 2011; 2: 74–5 (in Russian).</mixed-citation><mixed-citation xml:lang="en">Laushkina Zh.A., Filimonov P.N. Clinical and roentgenological peculiarities of pneumonia in patients of phthiziatrical hospital. Ftiziatriya i pul'monologiya. 2011; 2: 74–5 (in Russian).</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Radiology of the chest. National guidance of radiology and radiotherapy. Moscow: GEOTARMedia; 2014 (in Russian).</mixed-citation><mixed-citation xml:lang="en">Radiology of the chest. National guidance of radiology and radiotherapy. Moscow: GEOTARMedia; 2014 (in Russian).</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Vlasov P.V. Radiology of the chest. Moscow: Vidar; 2008 (in Russian</mixed-citation><mixed-citation xml:lang="en">Vlasov P.V. Radiology of the chest. Moscow: Vidar; 2008 (in Russian</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
