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患者 女性,49岁.咳嗽、咯痰伴痰中带血9天,疑右中叶肺癌入院.入院后咯血3次,最多时约200ml,色鲜红,经抗炎止血,咯血减轻.二十年前有咳嗽、痰中带血史.体检:体温38.6℃,气管居中,右肺呼吸音减低,两肺未闻及干湿性啰音.CT检查:右肺中叶见3.6cm×4.8cm肿块.诊断:右肺中叶癌伴肺门淋巴结转移首先考虑.纤支镜检查:右肺中叶癌.7天后行右中肺叶切除术.术中见:右中肺完全实变不张,外侧体段4cm×3cm×3cm大小肿块,支气管呈囊状扩大,内径1cm,内见陈旧积血及沙粒状沉积物,腔内自肿块向右支气管开口生长一茎状肿物,长达scm.镜下见肿物内有分化良好的鳞状上皮、皮脂腺、毛囊、软骨组织、脂肪组织及粘液腺.病理诊断:右肺中叶畸胎瘤.
Patient female, 49 years old. Cough, expectoration with sputum with blood for 9 days, admitted to the right middle lobe for admission to hospital. Hemoptysis 3 times after admission, up to about 200ml, bright red, hemostasis by anti-inflammatory, hemoptysis reduced. Cough, sputum blood history. Physical examination: body temperature 38.6 °C, tracheal center, right lung breath sounds reduced, two lungs did not smell and dry and wet rales. CT examination: right middle lobe see 3.6cm × 4.8cm mass. Diagnosis :Right middle lobe cancer with hilar lymph node metastasis first consideration. Fibrobronchoscopy: right middle lobe cancer. 7 days after right middle lobe resection. In operation see: right middle lung completely constricted, lateral mass 4cm × 3cm × 3cm in size mass, bronchial cystic expansion, internal diameter 1cm, see the old blood and sand sediments within the cavity from the tumor to the right bronchial opening to grow a stem mass, up to scm. See tumor under the microscope There are well-differentiated squamous epithelium, sebaceous glands, hair follicles, cartilage, adipose tissue, and mucinous glands. Pathological diagnosis: right middle lobe teratoma.