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find Author "沈旦" 2 results
  • Lymphoma manifested firstly as symptoms in respiratory system: nine cases report and literature review

    Objective To explore the clinical characteristics of patients with lymphoma firstly manifested as symptoms in respiratory system. Methods The clinical data of 9 patients with lymphoma were analyzed retrospectively and discussed with literature review. Results There were 7 males and 2 females with an average age of 48.2 years and a median disease course of 20 days. All patients were diagnosed by pathology while specimens were obtained by cervical lymph node biopsies in 2 cases, by CT-guided percutaneous lung biopsies in 2 cases, by bronchoscope mucosal biopsies in 2 cases, by transbronchial needle aspiration biopsies in 1 case, by thoracoscope lung biopsies in 1 case, and by ascites cell block inspection in 1 case. The main symptoms were cough (7/9), expectoration (3/9), fever (3/9) and wheeze (2/9). Chest CT showed tumors (3/9, multiple in 1 case), enlarged mediastinal lymph nodes (6/9), enlarged hilar lymph nodes (3/9), pulmonary consolidation (3/9), pleural effusion (6/9, bilateral in 3 cases), pleural thickening (2/9), pulmonary atelectasis (2/9), patchy shadow (7/9), pericardial effusion (1/9). Laboratory examination demonstrated elevated cancer antigen 125 (CA125) in 7 cases while elevated lactic acid dehydrogenase (LDH) in 4 cases. One patient died during hospitalization in the respiratory department, 1 patient auto-discharged without further treatment, 1 patient died in follow-up period. Five patients remain alive up to now. Conclusions The symptoms of patients with lymphoma are atypical while the chest radiological findings are varied. CA125 and LDH play important role in evaluating disease and predicting prognosis in patients with lymphoma.

    Release date:2017-04-01 08:56 Export PDF Favorites Scan
  • 肺朗格汉斯细胞组织细胞增生症误诊为肺肿瘤四例报告并文献复习

    目的探讨误诊为肺部肿瘤的肺朗格汉斯细胞组织细胞增生症(pulmonary Langerhans cell histiocytosis,PLCH)的临床特点,提高该疾病的诊治能力。方法收集本院4例初诊误诊为肺部肿瘤后经病理诊断的PLCH患者的临床资料,并回顾复习相关文献资料进行分析。结果4例PLCH中,男1例,女3例,年龄45~78岁。吸烟2例,不吸烟2例。临床表现2例为体检发现,1例发热,1例浅表淋巴结肿大起病。胸部CT表现为2例多发的肺囊肿、肺大疱改变,4例均出现结节影,其中3例为单发,1例双肺多发圆形小结节影,部分见空洞。3例行正电子发射计算机断层显像(positron emission computed tomography/X-ray computed tomography,PET/CT)检查的患者均提示肺部及淋巴结等病灶标准摄取值增高。4例患者均被误诊为肺部肿瘤,经外科手术、肺穿刺及气管镜等检查,病理见朗格汉斯组织细胞增生,结合S100、CD1a、Langerin等特征性免疫组织化学标志物,最终确诊PLCH。结论 PLCH临床表现不典型,影像学表现为肺结节及多发囊气腔改变需考虑PLCH诊断可能,PET/CT易误诊,通过活检行常规及特征性免疫组织化学病理检查可明确诊断。

    Release date:2023-04-28 02:38 Export PDF Favorites Scan
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