论文部分内容阅读
1 病历摘要患者,男,64岁,教师。因左肩胛区痛性肿块1个月余就医,开始感左肩胛区疼痛,乡间医院给祛痛、抗炎等对症处理、症状可暂时缓解,后经县医院行肩胛骨摄片,未见异常,给予局封治疗,效不显,且疼痛呈阵发性加剧,并感脊柱、骨盆、膝、髋等关节也疼痛,疼剧时需肌注杜冷丁方能止痛,乃来我院就医。查体:T37.2℃,营养中等,头颈部无异常,左肩胛区触及痛性肿块,无其它阳性体征;行局部肿块穿刺术,细胞学检查,病理诊断为转移性小细胞未分化癌;左肩胛骨摄片见宿胛岗下有1直径约3cm的不规则溶骨性占位病变,切线可见局部骨膜反应;该片边缘可见近左肺门处有直径约
1 medical records of patients, male, 64 years old, teachers. Due to the painful mass in the left scapular area for more than 1 month, she began to feel pain in the left scapular area. The village hospital gave symptomatic treatments such as aching and anti-inflammation, and the symptoms could be relieved temporarily. Afterwards, the county hospital performed scapular radiography without abnormality. The treatment given to the closure was ineffective, and the pain was intensified paroxysmal. It was also felt that the joints of the spine, pelvis, knees, hips, etc. were also painful. Intramuscular injection of dexamethasone was required to relieve pain and was used for treatment in our hospital. Physical examination: T37.2°C, moderate nutrition, no abnormalities in head and neck, painful mass in left scapular area, no other positive signs; local mass puncture, cytological examination, pathological diagnosis of metastatic small cell undifferentiated carcinoma The left scapular radiography showed that there was an irregular osteolytic lesion with a diameter of about 3cm under the SuoGangGang. The local periosteal reaction was seen at the tangential line; the left edge of the left hilum was visible at the edge of the slice.