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例1:患者男性,61岁,工人,因双腕肿痛1月余于1995年10月入院。患者原有肺结核病史,多次治疗,反复发作。体检:消瘦面容,贫血貌,左侧胸廓外观稍塌陷,听诊左肺呼吸音弱。双腕背侧均有肿块,压痛,不红.以右腕明显。X线摄片示右腕部软组织肿胀明显,右桡骨远端骨皮质破坏中断,毛糙,骨质结构有不规则的稀疏改变,并有轻度骨膜反应;左头状骨可见边缘不规则的骨质破坏区,无硬化,周围骨结构正常,左舟状骨边缘毛糙,亦有小部分骨质缺损表现。X线诊断:左腕骨、右桡骨转移性骨肿瘤可能?结核亦可能?建议穿刺活检。行纤支镜活检为左上肺鳞癌,双腕穿刺活检多次病理诊断为右桡骨左腕骨转移性肿瘤。患者因手术指征欠佳及经济问题而自动出院。
Example 1: A male patient, 61 years old, was admitted to hospital in October 1995 due to swelling and pain of both wrists for more than one month. The patient had a history of tuberculosis and had repeated treatment and repeated attacks. Physical examination: face was thin, anemia appearance, the appearance of the left side of the chest slightly collapsed, auscultation left lung breath sounds weak. There was a lump on both dorsal wrists, tenderness, and no redness. The right wrist was obvious. The X-ray film showed that the soft tissue of the right wrist was swollen. The destruction of the cortical bone of the distal right humerus was interrupted, rough, irregular sparse changes of the bone structure, and mild periosteal reaction. The left cranial bone had irregular edge of the bone. Destruction zone, no hardening, normal bone structure around, margin of the left scaphoid bone, and a small part of bone defect performance. X-ray diagnosis: Left carpal bone, right metatarsal metastatic bone tumor may be tuberculosis may also recommend biopsy. Fibrobronchoscopy biopsy for the left upper lung squamous cell carcinoma, double wrist biopsy pathological diagnosis of right patella left carpal metastases. The patient was automatically discharged from the hospital due to poor surgical indications and economic problems.