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患者,男性,67岁,农民。因“反复咳嗽、咳痰伴痰中带血4年,加重1月”于1999-10-24入院。患者从95年开始,曾先后两次在两家大医院诊断为肺结核,行正规抗结核治疗,病情控制。既往健康,否认有结核等传染病人接触史。家庭成员中亦无结核病史。查体:体温36.6℃,脉搏80次/分,呼吸20次/分,血压12/7Kpa。消瘦外观,贫血貌。全身浅表淋巴结均未及。双肺呼吸动度正常,左下肺叩诊呈实音,听诊呼吸音减弱。双肺未闻及干、湿性罗音。腹部体检无异常。入院检查:血常规红细胞总数2.29T/L,血红蛋白6.4g/L,余正常:ESR38mm/h,血生化均正常;多次痰检查均未见瘤细胞及抗酸杆菌;胸片、肺 CT 及 MRI 检查发现左下肺巨大囊性肿物,第8肋腋部骨质压迫、破坏;支气管镜及肺
Patient, male, 67 years old, farmer. Because of “repeated cough, phlegm with sputum bloody 4 years, increased in January ” in 1999-10-24 admission. Patients from 95 onwards, has twice in two large hospitals diagnosed as tuberculosis, regular anti-TB treatment, disease control. Past health, denied the contact history of infectious patients such as tuberculosis. There is no history of tuberculosis among family members. Physical examination: body temperature 36.6 ℃, pulse 80 beats / min, breathing 20 beats / min, blood pressure 12 / 7Kpa. Thin appearance, anemic appearance. No systemic superficial lymph nodes. Respiratory movement of both lungs normal, left lung percussion was solid tone, auscultatory respiratory sounds weakened. Unhealthy lungs, wet rales. Abdominal examination was normal. Admission examination: The total number of blood routine red blood cells 2.29T / L, hemoglobin 6.4g / L, more than normal: ESR38mm / h, blood biochemistry are normal; multiple sputum examination showed no tumor cells and acid-fast bacilli; chest X-ray CT and MRI examination revealed a huge left lower lung cystic mass, the eighth rib axillary bone compression, destruction; bronchoscopy and lung