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一项诊断难题:一名48岁不吸烟者的偶然发现的肺结节。

A diagnostic challenge: An incidental lung nodule in a 48-year-old nonsmoker.

作者信息

Christianson Blake Eric, Gupta Supriya, Vyas Shikhar G, Spartz Helena, Keshavamurthy Jayanth H

机构信息

Medical College of Georgia, Augusta, GA, USA.

Department of Radiology, Medical College of Georgia, Augusta, GA, USA.

出版信息

Lung India. 2018 May-Jun;35(3):251-255. doi: 10.4103/lungindia.lungindia_212_17.

Abstract

A 43-year-old female with a medical history of renal stones, hypertension, diabetes mellitus Type 2, and depression presented to her urologist with bilateral flank pain. She complained of worsening exertional dyspnea over the last several months with recent weight gain. She also endorsed night sweats and intermittent, scant hemoptysis over the past year. She denied fever, chills, nausea, vomiting, diarrhea, constipation, hematuria, or excessive joint or muscle pain. Physical examination was unremarkable. Computed tomography scan of abdomen and pelvis demonstrated bilateral nonobstructing renal stones and a 1.8 cm × 1.7 cm nodular opacity in the right lower lobe of the lung, not present on previous scan 1 year prior. Surgical wedge resection was performed and subsequent pathologic examination demonstrated a 1.2 cm × 0.6 cm × 0.5 cm soft, gelatinous well-demarcated mass in the right lower lobe wedge specimen without gross evidence of necrosis or hemorrhage confirming colloid adenocarcinoma of the lung.

摘要

一名43岁女性,有肾结石、高血压、2型糖尿病和抑郁症病史,因双侧胁腹疼痛就诊于泌尿科医生。她主诉在过去几个月中劳力性呼吸困难加重且近期体重增加。她还称过去一年有盗汗及间歇性、少量咯血。她否认发热、寒战、恶心、呕吐、腹泻、便秘、血尿或过度的关节或肌肉疼痛。体格检查无异常。腹部和盆腔计算机断层扫描显示双侧无梗阻性肾结石,右肺下叶有一个1.8厘米×1.7厘米的结节状不透明区,而1年前的上次扫描未显示。进行了手术楔形切除术,随后的病理检查显示在右下叶楔形标本中有一个1.2厘米×0.6厘米×0.5厘米的柔软、胶冻状、边界清晰的肿块,无肉眼可见的坏死或出血迹象,确诊为肺胶样腺癌。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4b9/5946561/1a2877c0cd97/LI-35-251-g001.jpg

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