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患者女性、38岁,因右胸刺痛半年余拟“结核性胸膜炎”于2003年2月11日入院。患者既往体健无肿瘤家族史。半年前曾在劳累后感觉右胸呈针刺样疼痛,无胀、钝、绞及放射状疼痛。症状呈间歇性发作,每月出现1～2次,经休息数天后可自行缓解,因症状能忍受患者一直未就诊。每次发病期间无畏寒、发热、咳嗽、咳痰、胸闷及气促等症状。本次因右胸刺痛加重到本院就诊,2003年3月17日 X 线胸片示:右侧大量胸腔积液(图1),拟“结核性胸膜炎”收入院。体检:体温37.4℃,浅表淋巴结无肿大,右胸廓塌陷、肋间隙明显变窄、叩诊为浊音且呼吸音低,两肺无干湿啰音。实验室检查:血清癌胚抗原(CEA)1.25 μg/L,胸液 CEA 0.01 μg/L。
A 38-year-old female patient was admitted to hospital on February 11, 2003 due to a right thoracic stab for six months. In the past, patients had no family history of cancer. Six months ago, after feeling tired in the right chest was acupuncture-like pain, no swelling, blunt, twisted and radial pain. Symptoms were intermittent seizures, 1 or 2 times a month, after a few days to rest on their own ease, because the symptoms can endure the patient has not been treated. During each onset without chills, fever, cough, sputum, chest tightness and shortness of breath and other symptoms. The right chest thorn ache aggravated to our hospital, March 17, 2003 X-ray showed: a large number of pleural effusion on the right (Figure 1), to be “tuberculous pleurisy” income hospital. Physical examination: Body temperature 37.4 ℃, superficial lymph nodes without swelling, right thoracic collapse, intercostal space was significantly narrower, percussion dullness and low breath sounds, both lungs without wet and dry rales. Laboratory tests: serum carcinoembryonic antigen (CEA) 1.25 μg / L, CEA 0.01 μg / L.