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中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (07) : 583 -585. doi: 10.3877/cma.j.issn.1674-0785.2020.07.024

所属专题: 经典病例 文献

病例报告

大量胸腔积液合并头皮结节误诊为结核病一例
谢平1, 陈彩萍1, 白茹1, 赵晖1, 刘纯波1, 刘亮明1,()   
  1. 1. 201600 上海交通大学医学院附属松江医院,上海市松江区中心医院感染科
  • 收稿日期:2020-01-28 出版日期:2020-07-15
  • 通信作者: 刘亮明

Massive pleural effusion with scalp nodules misdiagnosed as tuberculosis: a case report

Ping Xie1, Caiping Chen1, Ru Bai1   

  • Received:2020-01-28 Published:2020-07-15
引用本文:

谢平, 陈彩萍, 白茹, 赵晖, 刘纯波, 刘亮明. 大量胸腔积液合并头皮结节误诊为结核病一例[J]. 中华临床医师杂志(电子版), 2020, 14(07): 583-585.

Ping Xie, Caiping Chen, Ru Bai. Massive pleural effusion with scalp nodules misdiagnosed as tuberculosis: a case report[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(07): 583-585.

图1~2 患者入院前胸部CT平扫示双侧胸腔积液,右侧为大量,可见多发薄壁囊泡 图1为肺窗见多发囊泡,图2为纵隔窗见右侧大量胸腔积液
图3 头右顶部见一大小约7 cm×6 cm溃疡,表面少许渗液,溃疡边缘凸起肥厚;周边见2枚小结节,质硬,表面毛发脱落,并可见暗红色结痂样改变(箭)
图4~5 经胸腔积液引流后行胸部增强CT示右侧气胸,右肺组织压缩60%,双侧胸腔积液,两肺囊泡 图4箭示右肺囊泡,图5箭示两肺囊泡
图6~9 头皮结节活检病理结果 图6显示真皮及皮下组织中见大量异型细胞,细胞呈梭形或不规则形(HE染色,×200);图7显示高倍镜下见异型的核大、深染的瘤细胞(HE染色,×400);图8显示免疫组化CD31在皮损中呈阳性表达(×200);图9显示免疫组化CD34(部分+)在皮损中呈阳性表达(×200)
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