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患者女性,37岁。咳嗽、右上肢及右肩部疼痛4个月,近10天来呼吸及吞咽困难,咳白色粘痰,偶有血丝。查体急性病容,喘息状态。右侧瞳孔缩小,右服睑下垂、颜面水肿。气管左移,颈部皮下水肿(+)。右上肢水肿,皮下淤血。右肺呼吸音低,语颤减弱,音哑。右上胸部隆起,叩实音。实验室检查未见异常。临床拟诊右上纵隔肿物、气管囊肿、上腔静脉综合征而住院。X 线表现后前位胸片见右上纵隔有一块状阴影,密度均匀,边缘清晰而光滑。侧位片肿块占据上纵隔整个空间,并显示有较大的分叶状改变,肿块大小约12×13cm。
Female patient, 37 years old. Cough, right upper limb and right shoulder pain for 4 months, breathing and difficulty swallowing in the past 10 days, cough and sputum, occasional bloodshots. Physical examination of the disease, wheezing state. The right side of the pupils was narrowed, right ptosis, facial edema. Tracheal left, neck subcutaneous edema (+). Right upper limb edema, subcutaneous congestion. Right lungs have low breath sounds, weak lingoes, and dull sounds. The upper right chest is raised and solid sounds. No abnormal laboratory tests. The clinical diagnosis of right upper mediastinal mass, tracheal cyst, and superior vena cava syndrome was hospitalized. After the X-ray findings, the anterior chest radiograph showed a piece of shadow on the right upper mediastinum with uniform density and clear and smooth edges. The lateral lenticular mass occupies the entire space of the mediastinum and shows a large lobulated change with a mass of approximately 12 x 13 cm.