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1 临床资料 患者女性,58岁。干咳一月加重伴胸痛5天入院。曾用多种抗菌素及止咳药无效。体检:一般情况尚可。左眼眶上方及右小腿跟腱上方皮肤处有无毛大块黑痣各一处,黑痣无溃疡、搔痒等症状。肺外其它脏器未见异常。X线所见:右肺中叶外带见一直径3.5×2.5cm致密影,密度均匀,边缘清楚,有分叶及毛刺。余肺(-)X线印象;右肺中叶周围型肺癌。CT见:CT直接增强肺窗和纵隔窗右肺中叶外侧段见4.0×3.5×3.0cm呈分叶状有毛刺、周围有紊乱血管条纹,局部胸膜凹陷。肿块区CT值8～45HU(充血单位),纵隔内无肿大淋巴结,诊断与X线相同。手术见:右肺中叶外带近胸膜处见紫色块,
1 clinical data patients female, 58 years old. Dry cough in January increased with chest pain 5 days admitted. Has used a variety of antibiotics and cough medicine is invalid. Physical examination: the general situation is acceptable. Above the left orbit and the right lower leg Achilles tendon above the skin at the hairless large moles each one, mole without ulcers, itching and other symptoms. No other lung organ abnormalities. X-ray findings: the right middle lobe of the lung to see a diameter of 3.5 × 2.5cm dense shadow, uniform density, clear edges, lobulations and burr. Left lung (-) X-ray impression; right lung mid-peripheral lung cancer. CT see: CT directly enhanced pulmonary and mediastinum window in the middle of the right middle lobe see 4.0 × 3.5 × 3.0cm lobulated burr, surrounded by disorganized vascular streaks, local pleural indentation. Mass CT value of 8 ~ 45HU (hyperemia units), mediastinal no lymph nodes, the same diagnosis and X-ray. See the surgery: the right middle lobe of the lung near the pleura see purple block,