Acute silicosis in teflon-coated pan manufacturing due to metal sandblasting

Sandblasting is one of the occupational causes of silicosis. This report details three cases diagnosed as silicosis caused by sandblasting in Teflon-coated pan manufacturing: Case 1--A 24-year-old man admitted with dyspnea and cough; Case 2--An 18-year-old man admitted with shortness of breath and fever; and Case 3--A 25-year-old man admitted with dyspnea and weight loss. Chest examinations of the first and second cases revealed crackles in both lungs, but the third case was normal, no crackles. Chest x-rays showed bilateral reticulonodular densities and hilar enlargement in all cases. They were clinically and radiologically diagnosed as silicosis due to occupational exposure. All cases had worked in the sandblasting unit at a Teflon-coated pan manufacturing factory for one to three years. Silicosis is a preventable occupational lung disease, but no effective treatment is available for the disease yet. Improving workplace conditions is the most effective way to prevent silicosis.     

Acute Silicosis in Teflon-coated Pan Manufacturing Due to Metal Sandblasting

Abstract

Sandblasting is one of the occupational causes of silicosis. This report details three cases diagnosed as silicosis caused by sandblasting in Teflon-coated pan manufacturing: Case 1—A 24-year-old man admitted with dyspnea and cough; Case 2—An 18-year-old man admitted with shortness of breath and fever; and Case 3—A 25-year-old man admitted with dyspnea and weight loss. Chest examinations of the first and second cases revealed crackles in both lungs, but the third case was normal, no crackles. Chest x-rays showed bilateral reticulonodular densities and hilar enlargement in all cases. They were clinically and radiologically diagnosed as silicosis due to occupational exposure. All cases had worked in the sandblasting unit at a Teflon-coated pan manufacturing factory for one to three years. Silicosis is a preventable occupational lung disease, but no effective treatment is available for the disease yet. Improving workplace conditions is the most effective way to prevent silicosis.     

胸部CT在矽肺诊断中的意义

目的　评价胸部ＣＴ 检查在矽肺临床诊治过程中的应用价值。方法　对５８ 名长期接触矽尘的工人进行临床、Ｘ 射线平片、胸部ＣＴ 等检查, 该组病人平均年龄（５９ ±２） 岁, 平均接尘工龄２９ 年。结果　两种方法在大多数情况下其结果是类似的, 但对早期矽肺的诊断ＣＴ 片并不优于普通Ｘ 射线平片, 在８ 例经ＣＴ 检查诊断为０ ＋ 的病例中有２名Ｘ 射线平片检查诊断为矽肺Ⅰ期; 而对融合团块的发现, ＣＴ 检查要较Ｘ 射线平片检查敏感, 在经ＣＴ 检查发现的２７例有融合团块的复杂矽肺病例中, Ｘ 射线平片检查只发现２２ 例。另外对于矽肺合并症的诊断ＣＴ 检查对临床也很有帮助, 在合并肺癌的７ 例病人中, 均属经ＣＴ 检查证实, 在合并肺结核的１３ 例病人中也有９ 例经ＣＴ 检查证实。结论　胸部ＣＴ 与Ｘ 射线平片比较虽然不能发现更多的早期病例, 但能较早地发现团块融合改变, 此外对肺结核及肺癌等合并症的发现也很有价值。     

Duplicate origin of vertebral artery combined with brain tumor

A 59-year-old woman was admitted to our hospital with complaints of disturbance of consciousness. CT scan revealed right ventricular tumor, which was homogenously enhanced by contrast media. Left vertebral angiogram demonstrated a duplicated origin of vertebral artery. Right ventricular tumor, which was diagnosed choroid plexus carcinoma histologically, was successfully removed. Nine cases of duplicate origin of vertebral artery were analyzed from the literature. Our reported case was first brain tumor case with duplicate origin of vertebral artery.     

肺隔离症的64层螺旋CT诊断价值研究

目的探讨64层螺旋CT扫描在肺隔离症诊断中的价值。方法选取我院2008年12月-2013年4月肺隔离症患者24例,所有病例均行64层螺旋CT平扫及增强扫描检查,并进行图像后处理。结果24例患者中肺叶内型20例,占91．7％。其中发生于左肺下叶者20例,右肺下叶者4例。肺叶外型2例,占8．3％。结论64层螺旋CT增强扫描时间短,图像显示清晰,有多种图像后处理技术可供选用,能发现供血动脉及较小的病灶,对肺隔离症的诊断具有重要价值。     

肺结核合并肺炎误诊为肺癌患者结节或肿块的CT影像及相关原因

目的探讨肺结核合并肺炎误诊为肺癌患者结节或肿块的CT医学影像表现,总结误诊原因,为临床医师在今后工作中提供可靠依据,提高诊断正确率,降低误诊率。方法将对我院自2012年1月1日-2012年12月31日期间收治的75例肺结核合并肺炎患者临床资料进行回顾性分析,所有患者均使用CT医学影像检查技术诊断疾病,记录此类患者误诊为肺癌几率、患者体内结节、肿块的cT医学影像表现。结果75例肺结核合并肺炎患者经CT平扫误诊为肺癌几率为45．33％,显著高于经CT增强扫描误诊率8．oo％（P〈0．05）。结论肺结核合并肺炎、肺癌均无临床较为绝对的CT特异性影像表现,临床医师应实施CT增强扫描检测病灶中供血情况从而判断疾病。     

Infective tricuspid valve endocarditis due to abscess of an endogenous arteriovenous fistula in a chronic hemodialysis patient

Patients on chronic hemodialysis are at high risk for endocarditis due to prosthetic access devices. Right-sided endocarditis without any predisposing factors is rare in dialysis patients. A 76-year-old female, who had chronic renal failure had been treated by hemodialysis and had a permanent pacemaker implanted, was admitted to our hospital with a high fever and lumbago after abscess formation at an autogenous arteriovenous fistula for hemodialysis. Methicillin Resistant Staphylococcus Aureus was identified by blood culture examination. Echocardiography revealed vegetation attached to the tricuspid valve. Chest X-ray and perfusion lung scintigraphy showed pulmonary infarction, perhaps due to vegetation-derived emboli. Computed tomography also showed pyogenic spondylitis in L4 and L5. Repeated vascular punctures even of autogenous grafts expose dialysis patients to bacteremia and imply a higher risk of infectious endocarditis.     

Two cases of severe acute pancreatitis-CT scan was useful to the assessment

We report two cases of severe acute pancreatitis; a 53-year-old man (Case 1) and a 60-year-old woman (Case 2). Case 1 was classified as "severe" according to the Ranson's criteria and he died of MOF on the 21st hospital day. Case 2 was classified as "moderate", but a large pancreatic abscess was observed by CT scan. She died of this abscess complicated with duodenal perforation on the 33rd hospital day. CT findings showed that this case was not "moderate" but "severe". Therefore, we believe that the findings of CT scan are an important factor for assessment of the severity of acute pancreatitis.     

呼吸窘迫综合征并发支气管肺发育不良早期胸部影像的研究

目的：探讨新生儿呼吸窘迫综合征（NRDS）并发支气管肺发育不良（BPD）影像学表现及其意义，以提高对该并发症的胸部影像的认识，尤其是该并发症的早期胸部影像的认识。方法：选择2006年1月-2011年11月本院新生儿科收治的符合研究条件的新生儿呼吸窘迫综合征并发支气管肺发育不良（BPD）66例患儿，随访2年，出院诊断明确，有完整胸部影像资料和完整临床资料的病例，进行回顾分析。结果：本组NRDS治疗后并发BPD66例，治疗过程中平均治疗2-3周后复查影像检查，几乎所有并发BPD患儿胸片均开始出现“两肺透亮度减低，呈‘磨玻璃’样改变，两肺野可见斑片及云絮状阴影，边界模糊不清”表现，而且治疗过程中该影像较肺水肿影像持续时间长、吸收相对较慢。66例最终均出现不同程度的网格状囊泡状阴影改变，25例此后连续拍片影像无明显变化。结论：胸部影像是临床动态观察病情变化最直观、最方便、最快捷的首先方法，新生儿支气管肺发育不良的诊断主要根据临床病史及影像学资料，胸片、CT表现虽无特征性，但具有诊断意义，尤其是高分辨率CT能提供更多有价值的征象，有助于BPD的早期诊断，为临床及患儿尽早预防治疗赢得时间。     

Case report of intralobar pulmonary sequestration detected by lung cancer screening with low-dose spiral CT

A 52-year-old man underwent lung cancer screening with low-dose spiral computed tomography (CT) in a medical check-up at the Japanese Red Cross Kumamoto Health Care Center. He was asymptomatic. Chest x-ray on a medical check-up showed no abnormal shadows. CT scans revealed a nodule in the right lower lung, suggestive of its connection to the descending thoracic aorta. A diagnosis of pulmonary sequestration was considered. He was transferred to Kumamoto University Hospital for further examination. Contrast enhanced multidetector CT images demonstrated that a nodule in the right lower lobe and an anomalous artery ran from the descending thoracic aorta, flowed through the right lower lobe and returned to the right inferior pulmonary vein. Intralobar pulmonary sequestration was confirmed by contrast enhanced multidetector CT. We report this case of asymptomatic intralobar pulmonary sequestration diagnosed using contrast enhanced multidetector CT.     

Brain tumor or stroke?

Sometimes, the clinical presentation of a brain tumour mimics that of stroke or vice versa, as exemplified in the following three patients. In a 73-year-old patient the initial clinical picture was compatible with a brachial plexus lesion, as the weakness in his right hand appeared to have a traumatic, and not a central nervous system related, cause. When he experienced a focal seizure, the CT scan of the brain revealed a lesion in the motor cortex. This was presumed to be an infarction due to the lack of mass effect and the absence of contrast enhancement. Shortly afterwards the patient deteriorated and a follow-up scan revealed a large contrast-enhancing lesion. During surgery this proved to be a glioblastoma multiforme. A 76-year-old man was suffering from a progressive neurological deficit. An MRI scan of the brain revealed a contrast-enhancing lesion and a chest X-ray revealed an asymptomatic lung tumour; the diagnosis 'brain metastasis' was made. The surgeon removed the lung tumour, which proved to be a carcinoma. Later, when the patient was referred to the neurosurgeon for extirpation of the presumed brain metastasis, the MRI scan revealed that the lesion had decreased in size and no longer exhibited contrast enhancement. The metastasis proved to be an infarction. A 53-year-old man presented with sudden loss of consciousness due to a haemorrhage in the occipital lobe. An angiogram did not reveal a vascular malformation and during surgery no abnormal tissue was seen. The patient almost made a complete recovery. However, several months later he developed an elevated intracranial pressure due to a large occipital high-grade glioma, which had caused the original haemorrhage.     

对比低剂量CT扫描与X射线胸片对儿童肺炎支原体肺炎的诊断效果

目的:分析儿童肺炎支原体肺炎采用低剂量CT扫描与X射线胸片的临床效果。方法:选入2019年1月~2019年12月本院收治的肺炎支原体肺炎患儿80例作为研究对象,采用随机数字表法将其分成观察组和对照组,各为40例,对照组行X射线胸片检查,观察组行低剂量CT扫描,对比两种检测影像可见症状、准确率和漏诊率。结果:观察组影像可见症状均高于对照组,组间具有差异(P<0.05);观察组准确率高于对照组,且观察组漏诊率低于对照组,组间对比差异显著(P<0.05)。结论:对儿童肺炎支原体肺炎采用低剂量CT扫描,其准确率高于X射线胸片检查,误诊率较低,且影像可见症状更为清晰,有利于临床进行诊断。     

Congenital Pulmonary Airway Malformation (CPAM): A Case Report,Jimma University Medical Center,Southwest Ethiopia

BackgroundCongenital pulmonary airway malformation is a very rare congenital cystic lung disease that presents in 0.004% of all pregnancies and constitutes <25% of all congenital pulmonary anomalies in children. Respiratory distress is a major concern in these patients.Case DetailsHere in, we report an 8 month old girl presenting with exacerbation of fast breathing of three days duration. Chest X-ray showed hyper lucent right lung with significant shift of mediastinum to the left side, flattening of the diaphragm on the right side and compression of the left lung. Computed tomography scan of the chest revealed multiseptated cystic mass on the right lung measuring 8.9cm by 6.9cm. After receiving treatment for pneumonia, surgical excision of the mass was performed and biopsy showed congenital pulmonary airway malformation type1. The infant died on 40^th postoperative day from uncontrolled hospital acquired infection.ConclusionWhen a child has respiratory distress, congenital pulmonary airway malformation could be considered after common pathologies are ruled out. Surgical excision, which is the treatment of choice, is recommended to make a definite diagnosis and exclude hidden malignancies.     

X线平片与CT在脊柱损伤诊断中的临床意义

目的探讨CT扫描和X线平片在在脊柱损伤中的临床意义。方法对80例脊柱损伤患者的X线与CT资料进行回顾性分析。结果80例中X线平片发现椎体骨折60例,CT扫描发现椎体骨折70例,多椎体骨折16例,椎管狭窄12例。结论X线是脊柱损伤的基本诊断方法,CT扫描是全面观察脊柱损伤的重要手段之一。     

百草枯中毒肺损伤的X线、CT的表现特征与预后相关性分析

目的探讨百草枯中毒肺部损伤的X线、CT表现。方法对28例百草枯中毒患者的X线肺部平片和CT资料进行回顾性分析。结果 28例百草枯中毒患者的肺部X线和CT表现中毒时间变化而有差别。≤7d,21例表现肺纹理增多,16例磨玻璃样改变,3例肺实变,肺纤维化、胸腔积液2例,纵膈积气、心脏增大各1例;7～14d,肺纹理增多、肺实变及纤维化各6例,肺磨玻璃样改变5例;≥14d,肺间质纤维化7例,支气管扩张5例,肺纹理增多3例。结论 X线肺部平片、CT对观察肺部损伤的发展、演变及估计预后、确定治疗方案均有重要意义。     

不同影像学方法对周围型小肺癌诊断价值比较

目的总结比较不同影像学检查方法对周围型小肺癌的诊断价值。方法收集初诊为周围型小肺癌患者56例，全部病例临床资料齐全，均进行X线胸部正侧位平片、CT、MRI扫描检查，52例行CT引导下经皮肺穿刺活检，33例接受手术治疗，同时接受3—18个月追踪观察。结果初诊为周围型小肺癌的56例中，经进一步检查证实X线平片确诊12例（占21．46％），误诊44例（78．54％）；CT扫描确诊21例（占37．50％），误诊35例（占52．79％）；56例中有52例接受CT引导经皮肺穿刺活检，计58个病灶，共取材120次，平均2．07次，检查结果52例中恶性肿瘤38例（占73．08％）。52例中33例接受手术治疗，除3例与肺穿刺结果不一致外，其余诊断结果基本一致。经统计学分析，CT引导下经皮肺穿刺活检正确率为94．34％。结论通过四种影像学对周围型小肺癌的诊断价值比较认为：对于难以定性的肺结节病变应及时行CT引导下经皮肺穿刺活检．以免造成误诊和漏诊。     

不同影像学方法对周围型小肺癌诊断价值比较

目的总结比较不同影像学检查方法对周围型小肺癌的诊断价值。方法收集初诊为周围型小肺癌患者56例,全部病例临床资料齐全,均进行X线胸部正侧位平片、CT、MRI扫描检查,52例行CT引导下经皮肺穿刺活检,33例接受手术治疗,同时接受3~18个月追踪观察。结果初诊为周围型小肺癌的56例中,经进一步检查证实X线平片确诊12例(占21.46%),误诊44例(78.54%);CT扫描确诊21例(占37.50%),误诊35例(占52.79%);56例中有52例接受CT引导经皮肺穿刺活检,计58个病灶,共取材120次,平均2.07次,检查结果52例中恶性肿瘤38例(占73.08%)。52例中33例接受手术治疗,除3例与肺穿刺结果不一致外,其余诊断结果基本一致。经统计学分析,CT引导下经皮肺穿刺活检正确率为94.34%。结论通过四种影像学对周围型小肺癌的诊断价值比较认为:对于难以定性的肺结节病变应及时行CT引导下经皮肺穿刺活检,以免造成误诊和漏诊。     

CT血管显示率在子宫肌瘤、卵巢肿瘤中的应用价值

目的 探讨CT血管显示率在子宫肌瘤、卵巢肿瘤中的应用价值。方法 选取2017年5月—2019年5月我院收治的子宫肌瘤患者42例，以及同期我院收治的卵巢肿瘤患者42例，对入组患者分别进行CT平扫以及CT增强扫描，分析两种疾病CT检查特点以及CT平扫与增强CT扫描在疾病诊断中的应用价值。结果 卵巢肿瘤患者中内膜样癌患者4例，颗粒细胞癌患者13例，囊腺癌患者14例，囊肿患者2例，纤维瘤患者4例，畸胎瘤患者5例；子宫肌瘤患者卵巢静脉以及卵巢动脉显示率均低于卵巢肿瘤患者（P < 0.05），子宫肌瘤患者子宫动脉显示率与卵巢肿瘤患者无明显差异（P > 0.05），但子宫肌瘤患者子宫动脉显示率稍高于卵巢肿瘤患者；CT增强扫描在子宫肌瘤以及卵巢肿瘤诊断中阳性率明显高于CT平扫（P < 0.05）。结论 在对卵巢肿瘤以及子宫肌瘤诊断时可将卵巢动脉以及卵巢静脉的血管显示率作为诊断参考指标，卵巢肿瘤卵巢动脉以及卵巢静脉的血管显示率更高，通过增强CT扫描可以明确观察患者相关血管现象情况，且在疾病诊断中具有更高的诊出率，可以在临床中进行进一步推广应用。     

Diagnostic difficulties caused by a pulmonary infiltrate

Lung infiltration still causes differential diagnostic difficulties, which may delay the start of definitive treatment. CASE REPORT: The examination of a 30-year-old man began due intermittent, remittent and permanent fever. Chest X-ray confirmed infiltration in the right upper lobe, which was accompanied by elevated CRP and physiological levels of procalcitonin. Most likely atypical pneumonia, tuberculosis, Wegener's granulomatosis or a malignant process was suspected. Throughout his examination infection could not be verified, repeated CT guided transthoracic needle biopsy suggested the possibility of a malignant process. Through surgical exploration the intraoperative histology was not informative; thus, the pneumonitis-remodelled right lung was removed due to the possibility of malignant transformation. Histological examination revealed lymphocyte rich classical Hodgkin lymphoma, which was found to be stage IV/B based on the 18FDG-PET/CT scan; therefore, eight cycles of ABVD (adriablastin, bleomycin, vinblastine, and dacarbazine) therapy was administered successfully. The patient is currently (for 30 months) in a complete metabolic remission. CONCLUSION: Primary pulmonary Hodgkin lymphoma is a rare disease entity (in this case it might be the original process), in which the diagnosis is often difficult. 18FDG-PET/CT may be a useful early diagnostic tool investigating fever of unknown origin.