肺部CT平扫 有病理 过几天发 霉菌性肉牙肿
DSMXH
Posts: 365
Score: 26
女 20岁 一个月来头痛 近几天加重 恶心呕吐 其他正常
头颅CT无异常 肺部如下
application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check
application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check
XEYE
Posts: 61
Score: 5
右肺中野外带可见一病灶,以空腔为主,边缘光滑,无明显胸膜反应,空腔内壁光滑,可见内壁结节影,纵隔内未见肿大淋巴结影.
考虑肺内霉菌感染.
jyct
天山剑
丁香园准中级站友
Posts: 157
Score: 61 肺脓肿不太像:1没有发热的病史,2肺野内病灶周围也没有看见什么渗出性的
现,3.空洞不是典型的厚壁空洞,且空洞是偏心性的。
肺癌好像也不能考虑:1.患者女性20岁,年龄太轻。2.病灶虽然是偏心性的空洞但是没有明显的胸膜粘连和胸膜凹陷征象。
结核可能性不大:1.没有结核中毒症状,2.结核病灶常见于双上肺,3.结核出现空洞说明是慢性的表现,一般有其他肺野的播散。
考虑:
韦格纳氏肉芽肿可能:
患者女性20岁,正好是韦氏肉芽肿的好发年龄和性别。2.患者有头痛,可以查查有没有副鼻窦炎。3.韦氏肉芽肿的表现位于肺野边缘的团块影或空洞,一般多发, 但很多表现不是很典型,在园子里有不少韦氏肉芽肿的病例,表现不完全一样。
霉菌性的感染不能完全除外。
sdycwxj
application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check
丁香园中级站友
Posts: 516
Score: 161 1.右肺中叶外侧段胸膜下见一表面光滑类圆形软组织密度影,内见多个内壁粗糙不规则空洞影,病灶与胸膜粘连,胸膜反应不明显,余肺野未见明显异常,左侧胸腔背侧有新月形液体样密度影. 2.病史:女 20岁 一个月来头痛 ,近几天加重 ,恶心呕吐,其他正常.
3.定位:右肺中叶外侧段占位性病变.定性:首先考虑韦格纳氏肉芽肿.韦格纳氏肉芽肿是一种原因不明的少见病,可能与变态反应有关.可全身型或局限型,后者仅局限与肺内.次病30-50岁成人多见,大多数病人有鼻咽部相同改变,部分病人可无症状.约20%病例呈单发结节.边缘光滑或稍粗糙,呈厚壁空洞,内壁粗糙不规则,经治疗后空洞壁可变薄甚至完全消失.
nez040328
丁香园中级站友
Posts: 350
Score: 153 影响表现:右肺中叶见一单发结节影,形状不规则,但未见明显毛刺,内见含气腔,病灶前缘气腔似新月状,后缘气腔不规则,见小结节状影突入。病灶内未见钙化,周围未见卫星灶。中隔内未见肿大淋巴结,左胸腔少量积液。
临床:女性,20岁,头痛呕吐。
考虑为:右中肺霉菌感染 。患者头痛考虑为付鼻窦霉菌感染可能大(患者头颅CT正常)。 鉴别诊断:1,韦格氏肉芽肿。多表现为多发病灶,单发少见。无新月征。2,肺癌,有分叶和毛刺、空泡征、胸膜凹陷征。无新月征。且患者太年轻。3,脓肿:临床病史和影象表现均不符。
zzzsssjjj
Posts: 162
Score: 93 application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check
影像表现:右中叶外侧段见宽基底与胸膜相连的不规则块影,前后径明显大于上下径,边缘光滑,其内见多个边缘光滑的空洞,实性部分密度均匀,肺窗示不规则块影周围肺组织密度略增高,形成扇形影,近端与肺门血管相连,左侧胸腔积液。
诊断:结合患者有头痛,疑有副鼻窦炎,考虑肺韦格纳氏肉芽肿.
病理特点:血管炎和血管阻塞致缺血性肺梗死、坏死并形成空洞为本病特征之一。
鉴别诊断:肺霉菌感染,结节周围常见有“晕征”及空洞内“半月征”。
问
:上腔静脉入右心房处见金属丝影,原因,有手术史吗,
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病理结果为 霉菌性肉芽肿
application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check