论文部分内容阅读
患者男性,42岁.因右上腹胀痛半年伴低热、咳嗽40d入院.外院B超、CT示肝癌,并进行化疗3个月,病情无明显好转.年40d患者又出现低热、咳嗽、小便色黄,否认腹泻史,为求进一步诊治送来我院.入院查体:一般情况差,皮肤巩膜黄染,右侧腹股沟区可触及一个2cm×2cm的淋巴结,可活动.桶状胸,双肺叩诊过清音,呼吸音增粗.心脏听诊未见异常.腹软,肝肋下4cm、质硬、边钝,有压痛,脾肋下3.5cm、质硬、边锐,移动性浊音阴性.B型超过检查:应用HP-sonos100CF超声诊断仪,探头频率3.5MHz,常规位置扫查示肝脏体积增大,边缘尚规则,肝区光点粗细不均,并布满多个大小不等呈“牛眼症”样光团,周边境界清晰,有晕.较大的约3cm×2.5cm;胆囊大小正常,毛厚呈双边,囊内未见结石,胆总管内径正常,肝内胆管扩张,以左肝内胆管扩张明显;脾门厚径4.8cm,腹主动脉旁可探入多个大小不等弱回声光团,较大的约2.3cm×2.0cm;腹腔内可探及中等量的液性暗区.超声提示:①肝内多发性占位位病变②后腹膜占位性病变③肝内胆管扩张④脾大⑤腹水(中量).胸片示:双肺内可见多个大小相近形态相似
The patient was male, aged 42, with a history of mild hypothyroidism due to pain in the right upper quadrant for six months and coughing for 40 days. The B-ultrasound and CT showed liver cancer and chemotherapy for 3 months without any significant improvement. , Denied the history of diarrhea, for further diagnosis and treatment sent to our hospital admission examination: poor general condition, the skin scleral yellow dye, the right groin area can reach a 2cm × 2cm lymph nodes, can move .Breast thoracic and pulmonary percussion Over clear voice, breathing sound thickening heart auscultation no abnormal abdomen soft, liver ribs 4cm, hard, blunt edge, tenderness, spleen ribs 3.5cm, hard, sharp edge, mobility dullness negative. Exceed examination: The application of HP-sonos100CF ultrasonic diagnostic apparatus, probe frequency 3.5MHz, conventional location scan showed increased liver volume, the rules are still marginal, uneven thickness of the liver area, and covered with a variety of sizes ranging from “bull’s eye Disease ”light group, the surrounding state is clear, there halo. Larger about 3cm × 2.5cm; normal gallbladder size, bilateral hair thick, no intracapsular stones, common bile duct diameter, intrahepatic bile duct dilatation, to the left liver Expansion of the obvious internal bile duct; splenic door 4.8cm thick, next to the abdominal aorta can explore a number ranging from the weak echo light group, larger 2.3cm × 2.0cm; intraabdominal exploration and moderate amount of liquid dark area. Ultrasound Tip: ① intrahepatic multiple occupational lesions ② posterior peritoneal space-occupying lesions ③ intrahepatic bile duct dilatation ④ splenomegaly ⑤ ascites Volume). Chest X-ray showed: multiple similar to the size of the lung can be seen similar to the shape