This article reported a case of an elderly female patient with diffuse lung lesions and multiple enlarged lymph nodes. In the early stages of diagnosis, many clues, obtained through cellular immunology and molecular biology tests on a variety of samples including blood and bronchoalveolar lavage fluid, pointed to the diagnosis of tuberculosis. At the same time, a peripheral lymph node biopsy was conducted, which led to the diagnosis of lymphoma coexisting with tuberculosis, a"dual-diagnosis". In the subsequent treatment, lymphoma therapy was actively pursued while the patient's tuberculosis infection was treated, with good results observed in the follow-up treatments. When diagnosing the disease, the differential diagnosis must be integrated into the overall disease process, and avoiding rigid adherence to a "unitary"diagnostic concept.
本文报道1例双肺多发弥漫性病变伴有多发淋巴结肿大的老年女性患者，在诊断早期通过血液、支气管肺泡灌洗液等多样本，以及细胞免疫、分子生物学等多手段获得诸多结核的线索，同时进行外周淋巴结活检术后，通过病理结果初诊即明确为淋巴瘤合并结核的“二元论”诊断。在后续治疗中，兼顾患者结核感染的控制下积极地进行淋巴瘤治疗，随访治疗效果良好。在疾病诊断中，需把鉴别诊断放在诊断的全过程中，不能固守“一元论”的诊断思路。.