病例322:皮托拉克斯相关的淋巴瘤
Jiun-Yiing Hu1, Kyung Hee Lee1, Gabin Yun1
1From the Department of Radiology (J.Y.H., G.Y.) and Department of Radiology, Division of Cardiothoracic Imaging (G.Y.), University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA 15213; and Department of Radiology, Bundang Seoul National University Hospital, Seoul, South Korea (K.H.L.).
Radiology
|February 27, 2024
概括
一位患有癌症和结核病史的老年患者呈现出恶化的胸痛和呼吸障碍. 先进的成像和活检证实了诊断,导致适当的治疗开始.
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,膀瘤和先前结核性肺炎的病史,出现了新发的胸痛和呼吸障碍.
- 最初的评估显示活跃的结核病和偶尔发现的胸部病变与慢性活跃的炎症.
研究的目的:
- 为了调查患有复杂病史的患者胸部病变增长的原因.
- 为了区分慢性炎症,恶性瘤和复发性感染.
主要方法:
- 最初的CT导向活检显示慢性活性炎症.
- 随后,由于病变的进展和持续的症状,进行了对比度增强的胸部CT,重复CT导向活检和PET/CT.
- 监测了实验室检测,包括全血细胞计和C-反应蛋白.
主要成果:
- 最初的活检对恶性瘤没有确定性.
- 尽管进行了抗结核治疗,但病变显示间隔生长.
- 通过重复活检和PET/CT,最终诊断得到了确认,从而启动了向治疗.
结论:
- 患有癌症史和先前感染的患者的复杂胸部病变需要进行彻底和连续的评估.
- 像PET/CT这样的先进成像模式对于准确的诊断至关重要,当初始活检是非特异性的.
- 多学科评估是管理这些具有挑战性的案件的关键.
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