Male, cough with sputum (yellow sputum), low heat for three weeks, please diagnose!

Department ofRespiratory"Basic Information"male, 60-year-oldcoughing with sputum (yellow sputum), low fever three weeks"Image picture"discussion problems" how todiagnosis?discussioncomment: the lesion is located in the upper left lung lobe, no clear swelling of the lymph nodes, the lesions can be seen around the satellite stove and rope strip shadow, considerinfectionlesions;ofPathology Results Tracheostopharyosis: High-differentiated scale cancer"case summary"lung cancer is a malignant tumor that occurs in the upper skin of the bronchial mucosal, of which scale cancer is a more common type, accounting for about 40% to 50% of primary lung cancer, more than 50 years of age for men, more than 80% has a history of smoking, the tumor is good in the leaf, section bronchial fork, but l/3 to 1/4 in the small bronchial tubeimaging characteristics(i) central type1, early lung cancer:manifested as mild obstructive pneumonia or pulmonary disimagianceThe wall of the bronchial tube is slightly thickened, the intracavity nodules and the bronchial cavity are narrow, and lung cancer growth in the bronchial tube can cause bronchial blockage to be cut off2, progressive lung cancer:lung cancer is common, the edges are more clear, for soft tissue densityThe bronchial limitation tube wall thickens, causing bronchial narrowness and blockingThe narrow range of bronchial tubes is limited and the pipe wall is irregularcan also cause bronchial obstruction, which is gradually narrow or suddenly truncatedCT can clearly show the secondary change of bronchial obstruction, blocked pneumonia is characterized by plaque or lung segment, pulmonary leaf real changeThe often combined bronchial thickening is an image of obstructive bronchial dilationObstructive pneumonia often combines pulmonary inflated, at the same time the lung door enlargement or lumpObstructive pulmonary incongruity is mostly lung lobes or one side of the lungsWhen the lungs are not lumped together with the lung door lump, the density of the pulmonary gate area increases, or see the tumor outline The lung door lump shaves lower than the lung inflator during the enhanced scan CT enhancement scans are visible stripororor-like low-density shadows in the pulmonary incongruity, caused by the non-strengthening of mucus retained in the bronchial tube (ii) peripheral 1, early lung cancer: early peripheral lung cancer is less than 2cm of nodule image Early lung cancer nodules can be divided into solid density shadow, milled glass density shadow (ground-glass density shadow, GGDS) and part of the grinding glass density shadow, grinding glass density nodules can be seen in the blood vessels images tumor signs: lung cancer has an empty bubble sign or a thin bronchial image, the air-bearing image of several millimeters in the nodule the edge signs of tumor: most lung cancer edges are blurred, rough, leaf signs for the edge of the tumor is uneven performance, about 80% Vascular imaging can be available in the depression between the lobes, which is meaningful for the diagnosis of lung cancer peripheral signs of tumors: thoracic dents are more common, represented by a linear or triangular image between the tumor and the pleural The linear shadow is between the lump and the pleural, one or two, said to be a sign of "tail" or "rabbit ear" The triangle shadow is a curtain-like shadow between the lump and the pleural body that is pointed to the bottom of the lump to the pleural membrane 2, progressive lung cancer: tumor signs: tumor is a lump form, most tumor density is uniform Larger tumors can have calcification, the incidence of CT test calcification is about 6% to 7% CT checks can find calcified lesions that are difficult to display on flat sheets Plaque calcification is mostly located in the outer part of the tumor, mainly due to the original calcification package in the lungs during tumor enlargement, because of its high density, X-ray examination can also be shown Tumor tumor can form a hole, a thick wall hole, the hole wall is generally thick and uneven, the inner wall is uneven or irregular, there can be tumor nodule image the marginal signs of tumors: tumor leaf signs are more common But there are also lumps of the leaf is not obviously a shallow arc, some tumor edges smooth without split leaves The leaf signs of tumors are related to different growth rates in different parts of the tumor Tumor partial lung door side, bronchial tubes, blood vessels extended into the tumor site to form a recess cut, the tumor's pleural side chest into the tumor area can form a significant depression, these manifestations in the early peripheral type lung cancer can appear The edges of the tumor are more common, but the edges are clear tumor metastasis: peripheral lung cancer metastasis such as pulmonary nodules, cancerous lymphatic tubeitis, rib damage, pleural lumps, thoracic fluid, heart encapsulation fluid and lumps, converting and pulmonary door lymph nodes, etc., lung tip cancer (pulmonary groin tumor) often invades the chest wall and causes near-rib damage Source: Image Park