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find Author "王继旺" 2 results
  • 结节病伴乳糜胸一例并文献复习

    目的观察分析结节病伴乳糜胸的临床特征、诊断、治疗,以提高临床医生对该病的认识。方法分析南京医科大学第一附属医院病理确诊的首例结节病伴乳糜胸患者的临床资料,并检索复习 PubMed 的 10 例结节病伴乳糜胸患者的发病年龄、性别、临床表现、实验室检查、治疗和预后。结论本例为年轻男性患者,以胸痛、咳嗽为首发症状;胸部 CT 示全身多发淋巴结肿大,多发肺结节影,胸膜增厚,左侧胸腔积液及肺间质改变;胸腔闭式引流示乳糜胸;颈部淋巴结和支气管黏膜活检病理为非干酪样肉芽肿;经泼尼松治疗 9 个月预后佳。分析检索的 10 例结节病并发乳糜胸患者,以右侧乳糜胸为主,患者大多通过肺组织、淋巴结及胸膜活检确诊,治疗包括糖皮质激素、生长抑素、中链甘油三脂饮食、胸膜固定术及胸导管结扎术。对Ⅱ、Ⅲ期患者以糖皮质激素为基础的内科治疗大多数预后良好,Ⅳ期结节病伴并乳糜胸患者糖皮质激素治疗效果差,并发心肺功能不全可致死亡。结论乳糜胸是结节病的一种罕见并发症,与肉芽肿侵犯淋巴组织引起淋巴管阻塞有关,内科治疗大多预后好。

    Release date:2021-02-08 08:11 Export PDF Favorites Scan
  • Clinical characteristics, diagnosis and treatment of thoracic inflammatory myofibroblastic tumor

    ObjectiveTo explore the clinical characteristics, diagnosis and treatment of thoracic inflammatory myofibroblastic tumor.MethodsThe clinical data, pathological features, treatment and prognosis from 10 patients with thoracic inflammatory myofibroblastic tumor confirmed by pathology were analysed retrospectively from April 2012 to April 2019 at Jiangsu Province Hospital (The First Affiliated Hospital of Nanjing Medical University).ResultsTen participants including six males and four females with a mean age of 37.9 years old. Lesions were detected by physical examination in five patients, cough, chest pain and hemoptysis were the common symptoms. A total of 10 lesions including six in the right lung, three in the left lung and one in the mediastinum. Nine patients were treated with surgery, and one patient received high-frequency electrocautery though rigid bronchoscopy under general anesthesia. All the patients were confirmed by immunohistochemistry, positive rate of smooth muscle actin was 70%, positive rate of anaplastic lymphoma kinase was 70%. The mean follow-up time was 35.9 months, and one patient relapsed the other nine patients were cured.ConclusionsInflammatory myofibroblastic tumor is potentially malignant or low malignant, the clinical manifestations and imaging findings are not specific, once confirmed by pathology, radical surgery is the first choice. For the lesion limited to the airway, interventional therapy could be the choice, but close follow up is needed.

    Release date:2021-01-26 05:01 Export PDF Favorites Scan
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