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案例322 问题322

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此摘要是机器生成的。

一个有结核病史的81岁老人出现了恶化的胸痛和呼吸障碍. 先进的成像和活检证实了胸部病变,导致适当的治疗.

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科学领域:

  • 肺部病理学 肺部病理学
  • 在瘤学瘤学.
  • 传染性疾病 传染性疾病

背景情况:

  • 一名81岁的男性有尿道癌,膀瘤和结核性多病史,出现了新发的胸痛和呼吸不良.
  • 最初的CT显示胸部病变,活检显示慢性活性炎症.
  • 该患者最近完成了对活跃结核病的治疗.

研究的目的:

  • 为了评估患有结核病和癌症史的患者中正在增长的胸部病变.
  • 为了确定持续的呼吸道症状和白细胞病的病因.

主要方法:

  • 系列对比增强的胸部CT扫描.
  • 胸部损伤的CT导向活检.
  • 肝脏的MRI. 肝脏的MRI. 肝脏的MRI. 肝脏的MRI.
  • 通过PET/CT扫描.
  • 实验室检测包括全血细胞计和C反应蛋白.
  • 唾液培养. 唾液培养. 唾液培养. 唾液培养.

主要成果:

  • 最初的活检显示慢性活性炎症;唾液培养对结核病是负的.
  • 随后的CT显示了病变的间隔增长.
  • 症状恶化和炎症标志物 (白细胞病,C-反应蛋白) 的升高被注意到.
  • 重复活检和PET/CT证实了诊断.

结论:

  • 患有肺结核病史的患者的胸部病变可能会带来诊断挑战.
  • 高级成像和重复活检对于初步发现不确时的准确诊断至关重要.
  • 及时诊断和治疗对于管理复杂的胸腔病理至关重要.