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患者,女,76岁.因间断左胸痛2年,加重半月就诊.门诊胸透示左下肺一块状阴影,以“肺癌”于1993年9月收入院.胸痛呈针刺样,咳嗽及吸气时加剧,伴喘气,无畏寒、发热及咯血.30年前患“左侧结核性胸膜炎”.抗痨治疗后治愈,有“右侧支气管扩张”病史10年.查体:神清,T、Bp正常.浅表淋巴结无肿大,胸廓对称,左下肺呼吸音减低,右中肺可闻固定性湿啰音.心、肝、脾、肾等系统检查未见异常.辅助检查:患者三大常规、肝肾功能均正常,ESR47mm/h,肿瘤全套(一)及痰细胞学检查(一).胸片:左第2前肋下见密度不均匀阴影.2～3前肋间可见高密度钙化影,纵隔右移,结论:左肺巨大占位性病变.胸部B超:左肩胛线第7肋以下见9.7cm×8.1cm形态欠规则的混合性回声光团,边缘欠清晰,提示左胸腔巨大占位性病变.查肺部CT:左下肺可见5.0cm×6.0cm×7.0cm大小的卵圆形囊性占位性病变,囊壁可见广泛点状钙化影,邻近胸膜肥厚,结论:左下肺巨大结核瘤.肺部断层:左肺良性占
Patients, female, 76 years old, left chest pain for 2 years due to discontinuance, aggravating the half month treatment.The outpatient thoracic radiography showed a shadow of the left lower lung, “lung cancer” was admitted to the hospital in September 1993. Chest pain acupuncture-like, cough and sucking Gas increased, with gas, no chills, fever and hemoptysis .30 years ago suffering from “left tuberculous pleurisy.” After anti-tuberculosis treatment was cured, “the history of the right bronchiectasis” for 10 years. , Normal Bp superficial lymph nodes without swelling, symmetry of the thorax, lower left lung breath sounds decreased, the right lung can be heard fixed wet rales .At the heart, liver, spleen, kidney and other system examination showed no abnormalities .Auxiliary examination: three patients Routine, liver and kidney function are normal, ESR47mm / h, a full set of tumor (a) and sputum cytology (a) .Circuits: the left front two ribs see density uneven shadow .2 ~ 3 before the intercostal visible high Density calcification, right mediastinum, the conclusion: a huge left lung lesions .Both B: left shoulder scapular 7th rib to see the following 9.7cm × 8.1cm morphology owe regular mixed echo light group, the edge is not clear, Suggesting a huge left chest space-occupying lesions.Check lung CT: the left lower lung 5.0cm × 6.0cm × 7.0cm oval cystic lesions of the size of the wall can be seen a wide spot Shadow of two adjacent pleural thickening, concluded: left lung tumor pulmonary tuberculosis huge fault: the left lung benign accounts