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张某某,男,48岁。1985年4月起发热、咳嗽。拍胸片诊断为“肺结核”,抗痨治疗无效,8月30日入院。查:体温36.8℃,消瘦,表浅淋巴结不肿大。心肺无异常,神经系阴性,血及尿常规,肝肾功能均无异常。血流7mm/h。痰找癌细胞及结核杆菌阴性。胸片:右肺中野3×3.5cm致密阴影,外上方有毛刺,胸部CT:肺门及纵隔淋巴结无增大,诊断为周围型肺癌。 10月4日开胸手术,见右上肺尖、后段肿块6×5×5cm,表面光滑,未见肿大淋巴结。切除上、中肺叶作病理切片证实癌组织发生在尖段以下支气管壁,向腔内呈息肉状生长,上皮扁平,癌细胞排列成腺样或实片状浸及肺组织。病理诊断:肺
Zhang Mou, male, 48 years old. In April 1985, fever and cough began. The chest radiograph was diagnosed as “tuberculosis,” and the anti-tuberculosis treatment was ineffective. He was admitted to hospital on August 30. Check: body temperature 36.8 °C, weight loss, superficial lymph nodes are not swollen. There were no abnormalities in heart and lungs, negative neurons, routine blood and urine, and no abnormal liver and kidney function. Blood flow 7mm/h. He found cancer cells and was negative for Mycobacterium tuberculosis. Chest radiograph: Right lung 3 × 3.5cm in the middle of the wild dense shadow, outside the top burr, chest CT: hilar and mediastinal lymph nodes did not increase, the diagnosis of peripheral lung cancer. On the 4th of April, the thoracic operation was performed. The top right lung tip and the posterior segment of the mass were 6 x 5 x 5 cm. The surface was smooth and no enlarged lymph nodes were seen. Resection of the upper and middle lobes for pathological examination confirmed that the cancerous tissue occurred in the bronchial wall below the apex segment, and showed polypoid growth in the lumen. The epithelium was flat, and the cancer cells were arranged into adenoid or real-tissue leaching and lung tissue. Pathological diagnosis: lung