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PET-CT病例(广州军区总医院)病理结果出啦!
发起人:王欣璐  回复数:8  浏览数:8149  最后更新:2016-4-7 21:47:20 by 张星

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王欣璐 发表于 2010-12-21 17:53:41
PET-CT病例(广州军区总医院)病理结果出啦!

【病史】

   男,56岁。

  主诉:右背部疼痛,咳嗽,伴低热。

  外院CT示右肺两个占位性病灶,性质待定。

  既往史:既往有肝吸虫病史。

  PET/CT示:

1.  右肺上叶后段见一团块状放射性摄取增高影,大小约2.5cm×2.2cm×2.9cmSUV最大值为16.9,平均值为10.8CT于上述部位见软组织肿块影,CT值为26.5Hu

2.    右肺中叶内侧段(右心缘旁)见一团块状放射性摄取增高影,大小约3.0cm×2.5cm×2.9cmSUV最大值为10.7,平均值为8.6CT于上述部位见软组织肿块影,CT值为52.6Hu,中央部见形状不规则空洞影,周围见长毛刺征。

3.     左肺上叶尖段见一条状高密度钙化影。

4.     右侧肺门(10R)见一小结节状放射性摄取增高影,大小约1.4cm×1.2cmSUV最大值为5.0,平均值为3.4CT于上述部位见淋巴结稍增大影。

 

图1示右肺上叶后段高代谢肿块病灶

 

 

 

图2示右肺中叶内侧段(右心缘旁)空洞性高代谢病灶

 

 

 

图3示左肺上叶纤维索条及斑片影

 

 

图4 右肺上叶病灶肺窗

 

 

图5右肺中叶病灶肺窗

 

 

图6 右肺门高代谢结节病灶

 

 

 

 

 

 

 

 

 

 

宁小妹 发表于 2010-12-22 10:58:29
tuberculosis
zweibiao 发表于 2010-12-22 19:45:50

考虑:右中肺癌伴右肺上叶转移,右肺门淋巴结转移。

支持点:1、右肺中叶病灶见不规则空洞,可见壁结节,此为肺癌征象,鳞癌较多;右肺上叶病灶有明显毛刺。

       2、病灶代谢高,较均匀,提示右肺两个病变为同一性质,无结核新旧交替等不均匀现象。

       3、病灶同侧肺门淋巴结肿大,且代谢增高。

鉴别诊断:1、肺结核,左肺上叶有陈旧性结核灶,提示患者有结核基础,右肺中叶空洞壁密度较高,有钙化倾向(但病灶出现钙化,应为转归过程,代谢应较低吧,请版主指教)。

         2、肺内真菌感染。

         3,肺淋巴瘤。

王欣璐 发表于 2010-12-27 9:17:33

随访结果:患者行右肺上叶及中叶病灶手术切除,两个病灶病理均为腺癌,II级。右下肺门淋巴结1/4转移。

南-林 发表于 2010-12-27 20:10:20

肺内两个病灶一个有空洞一个没空洞

<div style="FLOAT: left">zweibiao
</div><div style="FLOAT: right"><a target=_blank href="javascript:BBSXP_Modal.Open('Reputation.asp?CommentFor=zweibiao',550,200);"> </div>

zweibiao 发表于 2010-12-28 12:30:37
oh~猜对了,结核会不会像这么高代谢呢,期待ing~
xufenghu5 发表于 2011-9-22 13:41:06
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张星 发表于 2016-4-7 21:47:20
学习了

 
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