-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
-
Cosmetic Ingredient
- Water Treatment Chemical
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
Only for medical professionals to read and refer to "Respiratory Defense War", waiting for you to see! Case profile Case 1: The patient, male, 65 years old, was admitted to the hospital more than one month after a physical examination revealed a pulmonary cavity.
Re-examination of chest CT after anti-infection treatment in the outside hospital showed no obvious changes in the lesions.
After admission, the blood carcinoembryonic antigen was checked at 5.
31↑ng/ml, and there were no obvious abnormalities in other indicators.
CT-guided percutaneous lung biopsy was performed, and the pathological report: invasive adenocarcinoma.
Case 2: The patient, female, 75 years old, was admitted to the hospital more than 2 years after the lung shadow was found.
2018-06-04 I went to an outside hospital due to a fall.
CT scan of the chest showed a ground-glass nodule (11mm×7mm) in the left upper lung, which was not taken seriously.
On March 9th, 2021, due to dizziness, I went to the Department of Neurology.
CT of the chest showed a ground-glass lesion (19mm×21mm) in the upper left lung.
He was treated with anti-infective therapy for 2 weeks (specifically unknown).
Re-examination of the chest CT showed that the lesion did not change significantly.
CT-guided percutaneous lung biopsy was performed, and the pathological report: invasive adenocarcinoma.
Case 3: The patient, male, 82 years old, was admitted to the hospital with cough and chest pain for half a month.
Chest CT revealed a solid nodule in the left upper lobe of the tongue, no obvious abnormalities in blood test, negative sputum acid-fast staining, and negative mycobacterial sputum sequencing.
After 3 weeks of anti-infective treatment, the chest CT was reexamined similarly, and the percutaneous lung biopsy was performed.
The pathological report: (left upper lobe lingual biopsy) inflammatory cell infiltration, epithelioid granuloma formation, complete coagulation necrosis, interstitial fibers Tissue hyperplasia with organizing, acid-fast staining (+), PAS staining (-), consider tuberculosis.
Case 4: The patient, male, 74 years old, was hospitalized with cough and sputum for 2 months.
Chest CT revealed a thick-walled cavity in the lower lobe of the left lung with enlarged left hilar lymph nodes.
The cytokeratin 19 fragment was measured at 20.
26↑ng/ml on admission. Underwent percutaneous lung biopsy, pathological report: lung squamous cell carcinoma.
Case 5: The patient, male, 72 years old, was admitted to the hospital in April after physical examination found shadows of the lungs.
Chest CT showed multiple nodules in the posterior segment of the right upper lung with enlarged right hilar lymph nodes, no obvious abnormalities in blood tumor markers, T-SPOT (+).
Electronic bronchoscopy + biopsy, pathological report: (posterior segment of right upper lobe) squamous cell carcinoma.
Case 6: The patient, male, 77 years old, was hospitalized with general fatigue and bone pain for more than 2 months.
At the beginning of 2021, the patient developed general fatigue, bone pain, and anorexia, which were not paid attention to.
On January 18, 2021, he went to the cardiology department of our hospital due to chest tightness.
A coronary CTA showed that the upper lobe of the right lung was occupied and the right hilar lymph nodes were enlarged.
On January 27, 2021, ultrasound-guided puncture biopsy of supraclavicular lymph nodes was performed, and the pathology showed that it tended to be neuroendocrine carcinoma, large cell type.
Case 7: The patient, male, 69 years old, was admitted to the hospital with a cough for more than 20 days.
Chest CT examination revealed a solid nodule in the anterior segment of the left upper lung.
Admission to the hospital for blood carcinoembryonic antigen 19.
57↑ng/ml, gastrin releasing peptide precursor 244.
4↑pg/ml, CT-guided percutaneous lung biopsy, pathological report: left upper lung small cell neuroendocrine carcinoma.
Case 8: The patient, female, 51 years old, was admitted to the hospital for one week with asthma and cough and sputum.
In mid-to-late November 2020, the patient developed asthma with cough, white sputum, and chest CT showed multiple diffuse lesions in both lungs, with a small amount of pleural effusion on both sides and partial inswelling of both lungs.
He was admitted to the hospital for blood tumor markers 37.
84↑ng/ml, white blood cells 12.
97↑×109/L, neutrophil ratio 83.
1↑%, and hypersensitivity CRP 67.
69↑mg/L.
Right thoracentesis, carcinoembryonic antigen in pleural effusion>1000↑ng/ml, abnormal cells were found in pleural effusion, and adenocarcinoma was considered in immunohistochemistry.
Case 9: The patient, female, 54 years old, was admitted to the hospital for 3 weeks due to asthma.
The patient was asthmatic, accompanied by cough, and a little yellow sputum.
CT of the chest showed mixed ground-glass lesions in the upper lobe of the left lung and the exudation around the lesion was slightly increased.
After anti-infective treatment, there was no obvious absorption improvement after reexamination.
The tumor was highly suspected in clinic.
Thoracic surgery was performed for thoracoscopic lobectomy.
Intraoperative rapid pathology showed invasive adenocarcinoma, and radical resection of left upper lobe lung cancer was performed.
Case 10: The patient, male, 71 years old, was admitted to the hospital with lung occupancy found for 1 year.
Chest CT showed a mass-like shadow of the left lower lung with cavities.
The blood tumor markers showed: carcinoembryonic antigen 9.
8↑ng/ml, CA199 59.
07↑U/ ml, the cytokeratin 19 fragment was measured at 42.
45↑ng/ml, the squamous cell carcinoma antigen was 6.
07↑ng/ml, and the neuron-specific enolase 38.
72↑ng/ml.
After eliminating the contraindications, CT-guided percutaneous lung biopsy was performed, and the pathological report: small cell lung cancer (SCLC).
★ Comments from experts: Li Liqun, Chief Physician, Department of Respiratory and Critical Care Medicine, Shanghai Public Health Clinical Center, Fudan University, Lung cancer is divided into two main types, namely SCLC and non-small cell lung cancer (NSCLC), of which NSCLC accounts for about 80% of all lung cancers.
The growth mode of SCLC is characterized by histological destruction and proliferation.
The higher the degree of malignancy, the faster the growth and division speed, the dense tumor body, the strong cohesion, the less fibrous component, the swelling growth, and the more balanced growth rate of each part of the tumor body, leading to the edge of the tumor.
Smooth and sharp, mostly circular or quasi-circular in imaging, with lobular signs more common.
SCLC has a high degree of malignancy, small lesions, and early metastasis and recurrence.
The most common histological types of NSCLC are adenocarcinoma and squamous cell carcinoma.
Adenocarcinoma cancer cells grow along the alveolar wall and gradually infiltrate the surrounding tissues.
With the progress of the pathological classification, the lesions gradually increased and the density increased.
The CT manifestations changed from the limited pure ground glass density shadow to the semi-solid to solid lesions.
As the degree of infiltration of the disease increases, the probability of air bronchial signs gradually increases.
Peripheral adenocarcinoma, due to the infiltration of the tumor tissue to the surrounding matrix, causes the elastic tissue to shrink, and the proliferating fibers pull the surrounding normal pleura, thus forming the pleural traction sign.
. Lung squamous cell carcinoma originates from the epithelium of the airway mucosa, the central type is mostly, and the peripheral type accounts for about 1/3.
The proportion of males is high, which is closely related to smoking.
The age is generally >50 years, and the incidence rate is about 30% of lung cancer.
Central squamous cell carcinoma is generally characterized by a mass with stenosis to truncation of the bronchus, accompanied by distal obstructive changes.
Peripheral squamous cell carcinoma can have small bronchial obstruction and truncation, forming an oval-shaped mass along the bronchial direction, and quickly breaking through the bronchus, forming a circular mass in the lesion area, and the distal obstructive pneumonia is not obvious.
The imaging of several cases shown in this article mostly requires differential diagnosis: Example 2 Mixed-density ground glass nodules in the left upper lung.
Generally speaking, the borders of inflammatory lesions are blurry, and the borders of tumor lesions are clear.
Sometimes inflammatory lesions are difficult to distinguish from peripheral lung cancer.
Nearly 50% of lung granuloma lesions undergo FDG-PET examination, and the SUV is higher than 2.
5.
In case 8, the pulmonary nodules were patchy, the bronchial vascular bundles were thickened, the interlobular pleura was involved, and the lobules were distributed centrally.
From the image alone, it also needs to be differentiated from vasculitis and infectious lesions.
Cavity lesions in cases 1 and 4.
The common features are: single lung lesions, compartments in the cavity, uneven wall thickness, and wall nodules.
Case 1 also has signs of vascular aggregation.
Need to distinguish with Wegener granuloma cavity.
The imaging characteristics of Wegener's granulomatosis: multiple, multiplicity, and variability.
There are multiple spherical lesions or wedge-shaped lesions near the pleura in the lung, with a diameter of 1-10 cm, sharp edges, and cavities.
The imaging of case 5 is an isolated nodule, with long burrs, shallow lobes, punctate cavities, especially the manifestations of vascular aggregation.
Malignant lesions must be considered.
The imaging findings of Case 3 did not consider tuberculosis first.
The patient’s diagnosis was unexpected, and it has repeatedly demonstrated the importance of pathological diagnosis.
Re-examination of chest CT after anti-infection treatment in the outside hospital showed no obvious changes in the lesions.
After admission, the blood carcinoembryonic antigen was checked at 5.
31↑ng/ml, and there were no obvious abnormalities in other indicators.
CT-guided percutaneous lung biopsy was performed, and the pathological report: invasive adenocarcinoma.
Case 2: The patient, female, 75 years old, was admitted to the hospital more than 2 years after the lung shadow was found.
2018-06-04 I went to an outside hospital due to a fall.
CT scan of the chest showed a ground-glass nodule (11mm×7mm) in the left upper lung, which was not taken seriously.
On March 9th, 2021, due to dizziness, I went to the Department of Neurology.
CT of the chest showed a ground-glass lesion (19mm×21mm) in the upper left lung.
He was treated with anti-infective therapy for 2 weeks (specifically unknown).
Re-examination of the chest CT showed that the lesion did not change significantly.
CT-guided percutaneous lung biopsy was performed, and the pathological report: invasive adenocarcinoma.
Case 3: The patient, male, 82 years old, was admitted to the hospital with cough and chest pain for half a month.
Chest CT revealed a solid nodule in the left upper lobe of the tongue, no obvious abnormalities in blood test, negative sputum acid-fast staining, and negative mycobacterial sputum sequencing.
After 3 weeks of anti-infective treatment, the chest CT was reexamined similarly, and the percutaneous lung biopsy was performed.
The pathological report: (left upper lobe lingual biopsy) inflammatory cell infiltration, epithelioid granuloma formation, complete coagulation necrosis, interstitial fibers Tissue hyperplasia with organizing, acid-fast staining (+), PAS staining (-), consider tuberculosis.
Case 4: The patient, male, 74 years old, was hospitalized with cough and sputum for 2 months.
Chest CT revealed a thick-walled cavity in the lower lobe of the left lung with enlarged left hilar lymph nodes.
The cytokeratin 19 fragment was measured at 20.
26↑ng/ml on admission. Underwent percutaneous lung biopsy, pathological report: lung squamous cell carcinoma.
Case 5: The patient, male, 72 years old, was admitted to the hospital in April after physical examination found shadows of the lungs.
Chest CT showed multiple nodules in the posterior segment of the right upper lung with enlarged right hilar lymph nodes, no obvious abnormalities in blood tumor markers, T-SPOT (+).
Electronic bronchoscopy + biopsy, pathological report: (posterior segment of right upper lobe) squamous cell carcinoma.
Case 6: The patient, male, 77 years old, was hospitalized with general fatigue and bone pain for more than 2 months.
At the beginning of 2021, the patient developed general fatigue, bone pain, and anorexia, which were not paid attention to.
On January 18, 2021, he went to the cardiology department of our hospital due to chest tightness.
A coronary CTA showed that the upper lobe of the right lung was occupied and the right hilar lymph nodes were enlarged.
On January 27, 2021, ultrasound-guided puncture biopsy of supraclavicular lymph nodes was performed, and the pathology showed that it tended to be neuroendocrine carcinoma, large cell type.
Case 7: The patient, male, 69 years old, was admitted to the hospital with a cough for more than 20 days.
Chest CT examination revealed a solid nodule in the anterior segment of the left upper lung.
Admission to the hospital for blood carcinoembryonic antigen 19.
57↑ng/ml, gastrin releasing peptide precursor 244.
4↑pg/ml, CT-guided percutaneous lung biopsy, pathological report: left upper lung small cell neuroendocrine carcinoma.
Case 8: The patient, female, 51 years old, was admitted to the hospital for one week with asthma and cough and sputum.
In mid-to-late November 2020, the patient developed asthma with cough, white sputum, and chest CT showed multiple diffuse lesions in both lungs, with a small amount of pleural effusion on both sides and partial inswelling of both lungs.
He was admitted to the hospital for blood tumor markers 37.
84↑ng/ml, white blood cells 12.
97↑×109/L, neutrophil ratio 83.
1↑%, and hypersensitivity CRP 67.
69↑mg/L.
Right thoracentesis, carcinoembryonic antigen in pleural effusion>1000↑ng/ml, abnormal cells were found in pleural effusion, and adenocarcinoma was considered in immunohistochemistry.
Case 9: The patient, female, 54 years old, was admitted to the hospital for 3 weeks due to asthma.
The patient was asthmatic, accompanied by cough, and a little yellow sputum.
CT of the chest showed mixed ground-glass lesions in the upper lobe of the left lung and the exudation around the lesion was slightly increased.
After anti-infective treatment, there was no obvious absorption improvement after reexamination.
The tumor was highly suspected in clinic.
Thoracic surgery was performed for thoracoscopic lobectomy.
Intraoperative rapid pathology showed invasive adenocarcinoma, and radical resection of left upper lobe lung cancer was performed.
Case 10: The patient, male, 71 years old, was admitted to the hospital with lung occupancy found for 1 year.
Chest CT showed a mass-like shadow of the left lower lung with cavities.
The blood tumor markers showed: carcinoembryonic antigen 9.
8↑ng/ml, CA199 59.
07↑U/ ml, the cytokeratin 19 fragment was measured at 42.
45↑ng/ml, the squamous cell carcinoma antigen was 6.
07↑ng/ml, and the neuron-specific enolase 38.
72↑ng/ml.
After eliminating the contraindications, CT-guided percutaneous lung biopsy was performed, and the pathological report: small cell lung cancer (SCLC).
★ Comments from experts: Li Liqun, Chief Physician, Department of Respiratory and Critical Care Medicine, Shanghai Public Health Clinical Center, Fudan University, Lung cancer is divided into two main types, namely SCLC and non-small cell lung cancer (NSCLC), of which NSCLC accounts for about 80% of all lung cancers.
The growth mode of SCLC is characterized by histological destruction and proliferation.
The higher the degree of malignancy, the faster the growth and division speed, the dense tumor body, the strong cohesion, the less fibrous component, the swelling growth, and the more balanced growth rate of each part of the tumor body, leading to the edge of the tumor.
Smooth and sharp, mostly circular or quasi-circular in imaging, with lobular signs more common.
SCLC has a high degree of malignancy, small lesions, and early metastasis and recurrence.
The most common histological types of NSCLC are adenocarcinoma and squamous cell carcinoma.
Adenocarcinoma cancer cells grow along the alveolar wall and gradually infiltrate the surrounding tissues.
With the progress of the pathological classification, the lesions gradually increased and the density increased.
The CT manifestations changed from the limited pure ground glass density shadow to the semi-solid to solid lesions.
As the degree of infiltration of the disease increases, the probability of air bronchial signs gradually increases.
Peripheral adenocarcinoma, due to the infiltration of the tumor tissue to the surrounding matrix, causes the elastic tissue to shrink, and the proliferating fibers pull the surrounding normal pleura, thus forming the pleural traction sign.
. Lung squamous cell carcinoma originates from the epithelium of the airway mucosa, the central type is mostly, and the peripheral type accounts for about 1/3.
The proportion of males is high, which is closely related to smoking.
The age is generally >50 years, and the incidence rate is about 30% of lung cancer.
Central squamous cell carcinoma is generally characterized by a mass with stenosis to truncation of the bronchus, accompanied by distal obstructive changes.
Peripheral squamous cell carcinoma can have small bronchial obstruction and truncation, forming an oval-shaped mass along the bronchial direction, and quickly breaking through the bronchus, forming a circular mass in the lesion area, and the distal obstructive pneumonia is not obvious.
The imaging of several cases shown in this article mostly requires differential diagnosis: Example 2 Mixed-density ground glass nodules in the left upper lung.
Generally speaking, the borders of inflammatory lesions are blurry, and the borders of tumor lesions are clear.
Sometimes inflammatory lesions are difficult to distinguish from peripheral lung cancer.
Nearly 50% of lung granuloma lesions undergo FDG-PET examination, and the SUV is higher than 2.
5.
In case 8, the pulmonary nodules were patchy, the bronchial vascular bundles were thickened, the interlobular pleura was involved, and the lobules were distributed centrally.
From the image alone, it also needs to be differentiated from vasculitis and infectious lesions.
Cavity lesions in cases 1 and 4.
The common features are: single lung lesions, compartments in the cavity, uneven wall thickness, and wall nodules.
Case 1 also has signs of vascular aggregation.
Need to distinguish with Wegener granuloma cavity.
The imaging characteristics of Wegener's granulomatosis: multiple, multiplicity, and variability.
There are multiple spherical lesions or wedge-shaped lesions near the pleura in the lung, with a diameter of 1-10 cm, sharp edges, and cavities.
The imaging of case 5 is an isolated nodule, with long burrs, shallow lobes, punctate cavities, especially the manifestations of vascular aggregation.
Malignant lesions must be considered.
The imaging findings of Case 3 did not consider tuberculosis first.
The patient’s diagnosis was unexpected, and it has repeatedly demonstrated the importance of pathological diagnosis.
