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按編號分類

Case 61-80

lat_1
72歲女性,主訴慢性乾咳多年,特別是夜裡較明顯,胸部X光檢查如上。

請仔細看CXR上retrocardia的部分有一陰影,此為hiatal hernia的case。
CT可發現胃的一部份跑到diaphragm以上。
ct-post_28
ct-post_30
PA
7歲女性病人,過去有polycystic liver disease及糖尿病史,主訴腹痛,全身無力逾一週,CXR如上。

答案是infected hepatic cysts with abscess formations and peritoneal rupture。
CXR上可見右側橫膈下有free air, 又上腹區又可以發現不正常radiolucency。
CT可見多個thin-walled cavities with air-fluid levels,peritoneal cavity內也有free air存在。
PA2
CT
CT2
PA470
Lat470
CT-1
CT-2
65歲女性病人,最近有咳血絲痰的情形,CXR及CT如上。

  • 答案是squamous cell carcinoma with cavitation。
  • CXR及CT可發現RLL有ill-defined margin,eccentric,thick-walled cavitation with air-fluid level,並有pleural retraction。
  • Squamous cell carcinoma is much more likely to caviate than cancers of other cell types. The cavity is frequently eccentric, the walls are often very irregular, usually at least 8 mm thick. Fluid levels are common, and necrotic tumor fragments may be seen within then cavity.
PA470
48歲男性病人,主訴呼吸困難及咳嗽六個多月,近一週有咳血絲痰的情形,並伴隨 6 Kg的體重減輕。

  • 答案是squamous cell lung cancer with right lung collapse。
  • CXR可發現 right hemithorax opacity及輕微的tracheal deviation to the right, 代表有volume reduction的情形,這點可以和massive pleural effusion所造成的hemithorax opacity做區分。
  • CT上可發現整個右肺幾乎被腫瘤所佔據,有少量的肋膜積水,肋膜有明顯增厚的現象,代表有pleural metastasis。
  • 右下肺有些樹枝狀影像,其中有air density也有fluid density,為air bronchogram以及fluid-bronchogram。Fluid-bronchogram的出現代表有airway obstruction。
CT-1
CT-2
CT-3
PA-2
40歲女性病人,無吸煙病史,主訴乾咳約半年,CXR表現如上。

答案是lung adenocarcinoma。
CXR應該可以看到heart後面的descending aorta line中途被interrupted,left heart border與gastric bubble後面都有double density,lateral view看到上述的LLL部位有solid mass density。
CT下可見huge mass with irregular margin (lobulated) and heterogenous intensity。
LAT470
CT-1
CT-2
CT-3

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