肺结核的症状、体征、X 线等表现与多种呼吸道及全身性疾病相混。最常需鉴别的是肺癌、肺炎、肺脓肿、慢支、支气管扩张、发热性疾病。肺癌:中心型在肺门处有结节影或有肺门纵隔淋巴结转移,需与淋巴结核鉴别;周围型在肺周围有小片浸润、结节,需与结核球或结核浸润性病灶鉴别。肺癌多为40岁以上,有长期吸烟史,一般不发烧,呼吸困难或胸闷、胸痛逐渐加重,常刺激性咳嗽、有痰血,进行性消瘦,有锁骨上转移者可触及质硬淋巴结,某些患者可有骨关节肥大征。 Tuberculosis symptoms, signs, X-ray and other performance and a variety of respiratory and systemic diseases mixed. The most commonly identified are lung cancer, pneumonia, lung abscess, chronic bronchitis, bronchiectasis, febrile illness. Lung cancer: the center of the hilar nodules or hilar mediastinal lymph node metastasis, the need to identify with lymph node tuberculosis; peripheral type in the lungs around a small infiltration, nodules, and nodular tuberculosis or tuberculous infiltration lesions identified. Lung cancer are more than 40 years old, have a long history of smoking, generally do not have fever, difficulty breathing or chest tightness, chest pain gradually increased, often irritating cough, sputum blood, progressive weight loss, with clavicular metastasis can reach hard lymph nodes, a Some patients may have osteoarthritis syndrome.