肺隔离症一例

病例资料　患者 ,男 ,2 7岁。因体检胸片发现左下肺肿块行ＣＴ检查 ,自诉无胸部不适及呼吸道症状。ＣＴ平扫 :左下肺后基底段类圆形实性肿块 ,密度均匀 ,ＣＴ值 3 5ＨＵ ,边界尚清楚 ,横断面范围 3 .0ｃｍ× 3 .5ｃｍ ,周围血管纹理明显增粗、增多 ,于肿块内侧隐约见一血管影与降主动脉相连 (图 1ａ) ;增强扫描及血管重建成像清晰显示肿块供血动脉来自降主动脉 ,并见分支血管附于肿块边缘 (图 1ｂ、ｃ) ,静脉回流至左下肺静脉 ,肿块本身无明显强化。ＣＴ诊断肺隔离症(叶内型 )。讨论　肺隔离症是一种肺的先天发育畸形 ,组织学上为一发育不良…     

少见部位肺隔离症一例

肺隔离症常见于两下肺 ,尤以左下肺多见。笔者发现 1例左上肺外型肺隔离症 ,报告如下。患者　男 ,18岁。体检胸片发现左上纵隔肿块 ,患者无自觉症状。查体及实验室检查无特殊。Ｘ线检查 :胸片示左上纵隔主动脉旁有一肿块 ,密度浅淡 ,与纵隔呈钝角 ,轮廓清楚 ,边缘光整、锐利 (图 1) ,侧位包块居中纵隔前方。ＣＴ扫描 :主动脉弓旁有一长梭形病灶 ,大小 5 .0ｃｍ× 2 .0ｃｍ× 3.0ｃｍ ,其内有斑点状密度不均匀病灶 ,边界锐利清楚 (图 2 ) ,ＣＴ值 1～ 5ＨＵ。诊断 :考虑为左纵隔包裹性积液或肉芽肿。手术所见 :包块位于主肺动脉窗 ,独立于肺…     

肺隔离症并发原发性恶性黑色素瘤1例

<正>男,45岁,反复咯血1年,再发20d入院。CT平扫+增强扫描示:左下肺见10cm×11cm肿块影,其内密度不均,见气-液平面,经肘静脉团注80ml碘佛醇,速率3ml/s,动脉期病变不均匀明显强化,见胸主动脉发出异常供血动脉,直径约5mm,拟诊左下肺肺隔离症并感染(见图1～3)。手术所见:左下肺实变,质硬,有结节,并见左下肺静脉下方有一异常动脉血供由降主动脉发出至左下肺,双重结扎     

肺隔离症1例

病人,男,49岁.2周前体检时发现左下肺肿物.胸部X线检查示:左下肺叶后基底段肿物.胸部CT检查示:左肺下叶低密度肿物.肺功能检查示:中度限制性通气功能障碍,低肺容量.     

肺隔离症1例

患者女,17岁。反复咳嗽、咳黄痰伴间断性咯血2年,左上腹痛半年。外院一直以肺炎、支气管扩张等疾病对症治疗,症状迁延。查体:左下肺呼吸音略低,左上腹部轻压痛,余正常。胸部CT检查(图1):左侧胸腹腔交界部囊性占位(肺隔离症不除外);左肺下叶支扩(轻度);腹部MRI检查(图2):左肾后上方、脾脏内侧占位,考虑为炎性病变。初步诊断:胸腔内占位;腹膜后肿物。2006年3月行手术治疗,术中见病变于左肺下叶,包膜完整,呈囊性,侵蚀膈肌,开膈肌探查肿物8cm×6cm大小,向下延伸至左肾上腺,有两支细小动脉来自腹主动脉,未发现异常回流静脉。断异常动脉,切除左…     

叶内型肺隔离症1例

病人,男,24岁.自5岁开始,间断出现咳嗽、咯痰、多伴发热,痰为黄色黏痰,量较多.9岁时因相似症状发作在当地医院就诊时,曾诊断为"肺囊肿".因此长期在当地住院治疗.近两年来患者自觉病情逐渐加重,易发热,痰量多,一般治疗效果变差.否认其他疾病,不吸烟.查体:发育良好,体格消瘦,右肺下野呼吸音低,无啰音.胸片示右下肺野一椭圆形阴影,约10 cm×11 cm 大小,轮廓清楚光滑,其内可见液平.诊断为右下肺囊肿伴感染.遂在全麻下行剖胸探查术.手术见:右侧胸腔广泛粘连.游离粘连后见右下肺内有圆形囊性肿物,大小约8 cm×8 cm×8 cm.囊壁薄而质韧.     

肺隔离症误诊1例

病例 男性,44岁。因咳嗽咳痰2月,加重1月于1998-01-05入院。两月前患者不明原因出现咳嗽伴低热。当地医院X光胸片示“双上肺结核”,经抗痨治疗1月症状无好转。复查胸片示右下肺片状阴影,MRI检查发现“右下肺占位病变伴右下肺不张”、“双上肺陈旧性肺结核”。纤支镜检查见右下支气管开口处少许脓性分泌物,灌洗液未查见癌细胞。因病人拒绝手术而以“肺癌”在门诊进行X刀治疗。此后患者咳嗽剧烈,夜间不能平卧,体温低热多在37.5-37.8℃之间,抗感染及对症治疗无效而入院。查体:137.2℃,P80次/min,双肺呼吸音粗糙,右下肺呼吸音消失。化验:WBC1·1×109/L,N80％。复查胸片示右下肺大片状阴影,其内密度不均,可见透光区。按放射性肺炎采用激素加抗感染治疗后症状好转,转外科进行手术治疗。术后证实为右下肺叶内型肺隔离症。     

肺隔离症螺旋CT诊断一例

病例资料　女 ,2 3岁 ,反复咳嗽 ,咳痰 4年。多次胸片诊断为左肺下叶炎性改变 ,经对症治疗后症状缓解 ,但左肺下叶阴影未完全消散。无咯血、脓痰及胸痛。查体 :胸廓无畸形 ,左下肺呼吸音稍弱 ,未闻及干、湿性音。实验室检查无异常。螺旋CT平扫 :左肺下叶后基底段紧邻降主动脉见 6 .0cm× 6 .2cm的不规则软组织肿块 ,其内密度不均匀 ,中心有低密度区 ,CT值为1 6～ 2 3HU ;降主动脉有一“漏斗状”软组织影与病灶相连 (图 1a)。螺旋CT血管造影示左肺下叶病灶周围呈环状强化 ,其内大部分为低密度无强化区 ,CT值8.4HU ;胸主动脉左侧壁有一…     

CT诊断肺隔离症1例

患者男,23岁.无明显自觉症状,健康查体,胸片发现左下肺心后区大片状密度增高影,X线诊断:左下肺炎.胸部CT平扫,左肺下叶后基底段见不均质软组织肿块,其前缘清楚,略膨隆,肺窗示病灶外侧呈网织状影.增强CT,病灶中度强化,其内见小囊状低密度影,胸主动脉左后方有一分支伸入肿块并显著强化,在相对低密度的病变内显得格外清晰(图1).CT诊断:左肺下叶肺隔离症.     

Bronchopulmonary sequestration: radiologic findings

Bronchopulmonary sequestration (BPS) is a nonfunctioning bronchopulmonary tissue that is separate from the tracheobronchial tree and receives arterial blood from the systemic circulation. BPS has a wide spectrum of imaging findings. Surgery is generally indicated for the treatment of BPS. It is important to demonstrate the arterial supply and venous drainage of the sequestered segment preoperatively. Today, with the help of noninvasive imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI), preoperative diagnosis of BPS can be made easily, so, invasive techniques such as angiography are not required frequently. In this report, radiological findings of BPS were retrospectively reviewed.     

Bronchopulmonary sequestration: CT assessment

Computed tomographic (CT) scans of 24 bronchopulmonary sequestrations in 23 patients were reviewed. Seventeen sequestrations were diagnosed at surgery, three at angiography, and four on the basis of radiographic or CT findings combined with appropriate history. Sixteen sequestrations were intralobar, and eight were extralobar; 21 were posterobasal. Seventeen occurred on the left side and seven on the right. Anomalous systemic arterial supply was demonstrated by CT in 16 sequestrations. In the others, a systemic artery was not shown, presumably because of unfavorable orientation or small size of the vessel. The lung abnormalities shown by CT were classified into three types: A = cysts containing air or fluid (n = 8), or soft-tissue masses (n = 2); B = emphysematous lung surrounding cysts, and/or soft-tissue nodules (n = 13); and C = lung hypervascularity (n = 2). In only three cases did the chest radiograph show the emphysematous lung tissue. Such emphysematous lung has rarely before been reported as a CT finding, and lung hypervascularity has not, to the authors' knowledge, been reported. The authors conclude that CT can be helpful in the diagnosis and evaluation of bronchopulmonary sequestration. Characteristic manifestations are (a) a complex lesion containing solid or fluid components combined with emphysematous lung or (b) any basal lesion supplied by a systemic artery.     

近端指间关节周围胶原沉积症1例报告

患者,男,16岁,因无痛性双手近端指间关节膨大3年余来诊。查体:发育正常,身体中等,双手指不短,十指近端指间关节对称性向两侧成梭状膨大,伸面和掌面不大,局部皮肤颜色、皮温正常,无破损,关节无压痛,活动自如。X线近端指间关节软组织肿胀,骨质无破坏(见图1~2)。实验室检查:血沉12     

Bronchopulmonary sequestration supplied from the renal artery

In a young lady who was examined for painless hematuria, a normally functioning sequestrated lung was found that was supplied from a branch of the right renal artery.     

肺隔离症3例

例1男，29岁。近2年来无明显诱因的咳嗽，咳白色粘痰。1年前曾咳痰带血，近8天来咳血性痰，并胸部不适。无胸痛、胸闷、心悸史。在当地医院诊为气管炎，经抗生素治疗效果可，但经常复发。自咳血性痰后，经外院胸部CT检查诊断为左肺下叶癌，并纵隔淋巴结转移，未经治疗而来我院就诊。体检：一般情况可，发育正常神志清，浅表淋巴结未触及     

肺隔离症1例

我院CT诊断肺隔离症1例,并手术证实,现报告如下. 患者男性,41岁.体检偶然发现右下肺肿块,无明显临床症状.正侧位胸片示:右下肺野见团块状密度增高影,边界清.CT平扫所见:右下肺脊柱旁类圆形软组织密度肿块影,边界清晰光滑,大小约94mm×106mm,其密度均匀,CT值约38HU,肿块周围见少量斑片状高密度影,边缘模糊.     

神经纤维瘤病1例报告

神经纤维瘤病,又称多发性神经纤维瘤,是一种少见的中胚层和神经外胚层的生长发育障碍性疾病,可累及全身各系统及器官,部分病例有家庭遗传史。1882年Von Recklinghausen完成了本病的病理研究,指出该病的实质是发生于神经纤维或神经干上的肿瘤样病变,所以也称为Von Recklinghaus-     

腺泡状肉瘤1例报告

1临床资料 患者,女,35岁,农民,右小腿包块3年.患者自幼轻度跛行,有右小腿疼痛史.3年前无意中发现右小腿后侧有一包块,初起如枣大,行穿刺治疗后包块增大较快.2002年11月以血管瘤手术,术后右小腿逐渐增粗,呈渐进性,近半年增粗迅速,并疼痛.查体:右小腿后侧隆起显著,皮色暗红,皮温高,浅静脉扩张,腓肠肌下方散在褐色色素沉着.腘窝处及小腿外侧可触及振颤,听诊小腿外侧明显吹风样血管杂音.胫前轻度凹陷性水肿,足踝区亦较对侧粗肿.实验室检查无异常.