Male, cough cough sputum 2 weeks chest tightness 1 week, please diagnose!

Respiratory Department of the Department of Respiratory Medicine (basic information) patients, male, 38-year-old "main complaint" cough cough sputum 2 weeks chest tightness 1 week (current medical history) patients 2 weeks ago no obvious cause of coughing cough sputum, symptoms gradually aggravated, 1 week ago chest tightness, no chest back pain, no cough blood.
"Image Pictures" "Discussion Questions" Diagnosis? Comment: The outer section of the middle leaf of the right lung can be seen in the density of throbular soft tissue, visible in the leaf and short burrs, and the bronchal blocking in the outer section.
enhanced scan visible enhancement.
consider the possibility of central lung cancer.
pathological diagnosis: Adenocarcinoma (Case Tichy) Central lung cancer occurs in the main bronchosis, pulmonary leaf bronchosis and pulmonary segment bronchosis.
growth type can be divided into tube type, tube wall type, tube type, of which the tube type mainly, adenocarcinoma, squamous cancer as the main pathological type.
pathological forms of the tumor include thickening of the thy bronchal wall, swelling in the tube cavity, and lumps around the bronchosis.
the growth of the tumor causes the bronchal narrow or blocked, which can cause obstructive emphysema, obstructive pneumonia and obstructive pulmonary failure, the so-called tri-blocking signs.
X-ray characteristics are as follows: 1. Early X-ray checks for no abnormal behavior.
2. With the progression of the patient's condition, the lung door area can be seen suddenly into the lungs, the edge of the clear lump shadow.
3. If tumor tissue blocks the airways, it can produce typical "three-block" imaging manifestations, namely obstructive emphysema, obstructive pneumonia, obstructive pulmonary failure, of which obstructive pulmonary disease is the most common.
obstructive pneumonia - when the tumor blocks the airways, the corresponding lung segment, lung leaf area has a fuzzy strip-like shadow or a skewer-like shadow, the density is uniform.
obstructive emphysema - if the volume of the lung leaf significantly increases, the lung texture is sparse, the transparency is higher, and the cross-section and the diaphragm can be shifted under pressure.
the lungs - if the airways are completely blocked, flaky lungs can be uns shaded.
4. Accompanying pulmonary lymph node swelling, its lower edge has an inverted "S"-shaped shadow, that is, central lung cancer, is a typical sign of central lung cancer in the upper right leaf.
CT characteristics are as follows: 1. Early CT examination can be seen that the pipe wall has a mild thickening condition, and there are small nods in the tube cavity, tube cavity blocking or narrow.
signs of the middle and late stage: bronchary obstruction, stenosis, pulmonary lumps, most obvious to bronchoclerosis.
narrow bronchon - mainly manifested as smooth or irregular inner edge of the tube cavity, thickening of the pipe wall.
the bronchon blockage - mainly manifested in the tube cavity after thinning blocking, the tube cavity suddenly cut off.
lumps in the lung door - mainly manifested in the smooth outer edge of the lung door area, or the appearance of leaf-like soft tissue lump shadow.
3. Indirect signs in the middle and late stage: tumors do not completely block the bronchial tube - obstructive emphysema; tumors completely block the bronchial tube - the corresponding area has obstructive pulmonary failure, obstructive pneumonia and so on, CT performance is a patch-like fuzzy shadow, or lung leaf, lung segment real shadow.
after an enhanced scan, its narrow bronchosis appears clearer against a significantly reinforced, unsopired lung leaf.
diagnosis: 1. Obstructive pneumonia of central lung cancer needs to be distinguished from general pneumonia.
obstructive pneumonia is not easily absorbed by anti-inflammatory treatment, or after absorption in a short period of time.
often combine lung doors and lymph nodes to swell.
2. The lungs of central lung cancer need to be different from the benign lungs.
tuberculosis and pneumonia pulmonary tubes at all levels of smooth, there are air bronchitis, no lung lumps.
tuberculosis-induced lungs are invisible hollows, calcified stoves and satellite stoves.
ct examination should pay attention to the relevant bronchon wall thickening, narrow tube cavity, blocking.
thin layer or high-resolution CT can show the bronchon cavity pattern more clearly.
3. The narrow manifestations of bronchosis in central lung cancer need to be distinguished from the narrowness of bronchon tuberculosis.
narrow range of bronchon tuberculosis is longer, which can affect both the main bronchosis and the leaf and section bronchosis, and there is a change in tuberculosis in the lungs.
4. The tumor in the bronchal tube of central lung cancer needs to be distinguished from the benign nosedles of the bronchosis.
the benign lesions of the bronchal tube have faulty tumors, inflammatory nods, etc., the edge of the benign nods is smooth, and the bronchal wall is not thickened.
source: Image Park !-- the end of the content display -- !-- to determine whether the login ends.