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患者女,56岁,因胸闷、咳嗽、痰少,进行性加重1月,于1989年11月27日入院.体格检查 胸廓无畸形,右下肺语颤弱,呼吸音弱,叩诊右腋背第7肋以下呈浊音.同侧椎旁为清音.右腋下闻及少许胸膜摩擦音.肝脏(一).化验:血沉110mm/小时,癌胚抗原0.7μg/L(正常值<0.2μg/L),甲胎蛋白(一).痰脱落细胞4次均(一).胸片:右前位见右下肺野大片致密影,右肺肋角消失.侧位肺中叶见半圆形致密影,边界清.头低脚高位见右下肺有一10×10cm大小圆形增密影,密度均匀,边缘光整,侧位见于后纵隔.B超:右侧胸腔内实质性肿块,肝脏受压.CT扫描增强前后见上腹及右侧下胸部,后纵隔旁实质性占位,约有90×97mm大
A 56-year-old woman, who developed chest tightness, cough and sputum, was progressively aggravated for one month. She was admitted to the hospital on November 27, 1989. Her physical examination revealed no deformity of the thorax, weak whispered right whisper, and weak breath sounds. Below the 7th rib was dull sound. Ipsilateral paravertebral was unvoiced. Right squat heard a little pleural friction sound. Liver (a). Laboratory tests: ESR 110mm/h, carcinoembryonic antigen 0.7μg/L (normal value <0.2μg/L ), alpha-fetoprotein (a). 痰 exfoliated cells are four times (a). Chest: right front view of the right lower lung field large dense shadow, the right lung rib angle disappears. Lateral lung middle leaf see semicircle dense shadow, Border clear. The head of the lower left foot see a 10 × 10cm size circular thickening shadow of the lower right lung, the density is uniform, the edge is smooth, the lateral position is seen in the posterior mediastinum. B-ultrasound: a solid mass in the right chest, liver pressure. Before and after the CT scan, see the upper abdomen and the right lower chest, the substantial space after the posterior mediastinal, about 90 × 97mm large