高分辨率肺部ct诊断（下）

《高分辨率肺部ct诊断（下）》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、Case61ina73-year-oldwomanwithcough支扩大边界不清的结节树芽征Whatisthemostlikelydiagnosisinthispatient最可能的诊断?(a)Bacterialbronchopneumonia细菌性支气管肺炎(b)Tuberculosis肺结核(c)Infectionwithatypicalmycobacteria非典型分支杆菌感染InfectionwithatypicalmycobacteriaCorrect.Inanelderlywoman,thecombinatio

2、nofbronchiectasis,nodules,andtree-in-budishighlysuggestiveofMACinfection支扩、结节、树芽征高度暗示分支杆菌感染。Case62ina35-year-oldmanwithleukemia白血病Onthelungwindowscan,alungnoduleissurroundedbyahaloofground-glassopacity磨玻璃晕征.Thisistermedthe“halosign晕征”.Onthesofttissuewindowscan,low-

3、attenuationnecrosisisvisibleinthecentralportionofthenodule结节中心可见坏死.晕征坏死Diagnosis:Invasive入侵的aspergillosis曲霉病withthe“halosign晕征"Case63ina28-year-oldmanwithleukemia白血病andtreatedaspergillosis曲霉病治疗不规则的空洞结节影像Diagnosis:Invasiveaspergillosis曲霉病withinfarction坏死andair-cresc

4、entsign新月征Case64ina31-year-oldwomanwithanabnormalchestradiograph异常胸部表现.Diagnosis:Wegener‘sgranulomatosiswithmultiplenodules韦格纳肉芽肿DISCUSSION：Largelungnodulescanbeassociatedwithavarietyoflungdiseases,andinmostinstances,theirappearanceisnonspecific无特殊性.Thedifferential

5、diagnosis鉴别诊断includesmetatstatictumor转移瘤,infectious感染orinflammatorylesions炎性损害,infarctions肉芽肿病,nodulesofWegener‘sgranulomatosis,sarcoidosis结节病,andfibroticmasses纤维块asarecommoninsarcoidosisorsilicosis在结节病、硅肺病.INCREASEDOPACITY肺不透明性增加Case65ina35-year-oldwomanwhohasahis

6、toryofasthma哮喘史,progressiveshortnessofbreath进行性喘憋DoestheprincipalabnormalityvisibleonCTrepresentconsolidationorground-glassopacity首要异常是实变还是磨玻璃改变?(a)Consolidation实变(b)Ground-glassopacity磨玻璃密度ConsolidationCorrect.HRCTshowspatchyareasofconsolidationinthelungperiphery肺

7、外围不均的实变.Notethatvesselsarenotvisiblewithintheareasofincreasedopacity密度增高影内肺血管影像未见.Someareasofgroundglassopacityarealsovisible一些磨玻璃区是可见的.实变Diagnosis:Chroniceosinophilicpneumonia慢性嗜伊红肺炎,presentingwithconsolidation呈现实变。Case66ina43-year-oldwomanwithalow-gradefever低热,pr

8、ogressiveshortnessofbreath气短肺外围实变影Therewasamarkedeosinophiliaintheperipheralblood外围血嗜伊红细胞增多.Themostlikelydiagnosisis最可能的诊断:(a)BOOP机化性肺炎(b)pneumon