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鉴别诊断 Salhanick医师:让我们先了解一下超声检查的情况吧。 Ferrucci医师:右侧肾脏和肾上腺部位超声检查证实,在肾脏中线的前方有一个直径为4cm的圆球形结构,这个结构符合增大的肾上腺。尽管在病历上记录此结构为囊肿性,然而,它没有明显的后壁,也不象充满液体的囊肿那样地透射超声波束,而是反映一个均匀的实体病变。左侧显然无病变,其他X线检查无诊断价值。未见卵巢增大。 Salhanick医师: 本例患者表现男性化伴有闭经、慢性肝炎、甲状腺机能亢进和自身免疫性疾病的征象。第一个问题涉及闭经与男性化的关系。患者月经初潮发生于15岁,稍晚于平均年龄。然而,患者受到几种可能推迟月经
Differential diagnosis Dr. Salhanick: Let us first understand the ultrasound examination of the bar. Dr. Ferrucci: Sonographic examination of the right kidney and adrenal area confirmed that there is a 4 cm diameter circular sphere in front of the midline of the kidney, which conforms to an enlarged adrenal gland. Although the structure was recorded as cystic in the medical record, however, it had no apparent posterior wall and did not transmit the ultrasound beam as a liquid-filled cyst but reflected a homogeneous physical lesion. Apparently no lesions on the left, no diagnostic value of other X-ray examination. No ovarian enlargement. Dr. Salhanick: This patient showed masculinity with signs of amenorrhea, chronic hepatitis, hyperthyroidism and autoimmune diseases. The first question concerns the relationship between amenorrhea and masculinity. Menarche occurred in patients aged 15 years, slightly later than the average age. However, there are several patients who may postpone menstruation