The alveolus albumen deposits disease and amalgamates a _'s treatment of lymphoma

The alveolus albumen deposits disease and amalgamates a _'s treatment of lymphoma
It is a kind of rare lung filling the air disease that the alveolus albumen deposits disease, the cause of disease is not clear, not radically treating the method yet at present, there are also few reports of our country, the alveolus albumen deposits the rare report of person who amalgamates lymphoma of disease. This text report deposited disease to amalgamate one lymphoma by the alveolus albumen that pathology verifies.
Clinical materials
Patient, male, 58 years old, because cough, expectoration, 5 of shortness of breath, aggravate and generate heat, I in January, admitted to hospital on February 16, 2003. Because the patient coughed in March of 1998, expectoration is half a year, aggravated companion's shortness of breath and is admitted to hospital in half a month. Through chest slice, lung C T (see Fig. 1) after admitted to hospitalling Check, it is mainly shown as one pair of lung essences has exudative pathological change that filling the air density increases, like the feather, take the form of butterflies and is distributed, the focus is not of uniform size, the edge is fuzzy, the density is relatively even, obvious with two poor lungs, the lung doors and mediastinal lymph nodes are not swelling. Fibrous the intersection of bronchus and the intersection of mirror and lung examine pathology, slice while being living: Most alveolus are expanded, is full of albumen materials of granular, wadding, P A S dyes the masculine gender, is dyed hard and bluely negatively, thus make a definite diagnosis of and deposit disease for the alveolus albumen. Irritate, wash, treat 7 through fibrous the intersection of bronchus and the intersection of mirror and competent the intersection of bronchus and alveolus in hospital, irritate the washing amount 8002000m l and does not wait for resisting the inflammation treatment at the same time each time, symptom is obviously relieved, reexamine one scene of focuses of chest to obviously absorb, left hospital in April of 1998. Because cough on the 8th of 1999 dates, shortness of breath and symptom recur and generate heat to the local hospital to go to a doctor, diagnose as " The alveolus albumen deposits disease and amalgamates lung and is infected with pulmonary tuberculosis " ,Resist inflammation and treat 7d, isoniazid, rifampin, second amine cube alcohol and Streptomycin resist consumptive disease treatment for 9 months. Because symptom takes place and aggravates before January, cough yellow phlegm, generate heat, the body temperature goes to the local hospital to go to a doctor at 3838.5, consideration is " The alveolus albumen deposits disease to amalgamate and infect " ,It give in hospital to if you can't fill in on rice, loose 5m g quiet to push away /day,and whether last inflammation to last 12d Klim very beginning spore Qusong and Fluorine health thiazole,etc.s plains mould, symptom has not taken a favorable turn. Symptom became more serious before 10d, shortness of breath is obvious, generated heat the body temperature is up to over 39 , night sweated, entered my department agained. Get up and receive difference after being ill, the stool and urine is normal. There is essential hypertension previously. Admitted to hospital the physical examination: Body temperature 39.5 , pulse 160 time /divide,breathe by 24 times divide, blood pressure 140/80m m H g, arterial oxygen saturation ( S p O 2) 89%, it is slightly rapid to breathe, the simple table lymph node is not big, two lung respirations are thick, can hear and a large number of wet rales, heart circle is big,heart rate 160 times /divide,soft in belly, there are big in spleen on liver, pairs of lower extremities getting more swollen. Blood routine examination: There are normal on hemochrome and blood platelet,leucocyte 9.7* 109 L,unless neutral 89.6%, lymphocytic 7.4%,artery vim and vigour (at the time of oxygens upper: F I O 22L /m i n ) p H 7.53,P C O 230.3m m H g , P O 264.1m m H g . The total albumen 53.4g L, albumin of liver function: 28.8g L, globulin 24.6g L. The fat of blood, renal function, electrolyte are normal, the pure egg of tuberculosis derivative (P P D) I g G, I g M, gold mark the intersection of tuberculosis and antibody (form, test tomorrow) It is negative.
Erythrocyte sedimentation rate: 62m m h, 2 little globulin 3.73m g L (normal 0.912.26 m g L) ,L D H L U L (normal 109245U L) . The phlegm is trained: Do not work the sour bacillus of rafter of the Chinese holly of place. Lung C T: Pairs of wild to present person who fill the air, rub hyaline the intersection of density and shadow of increasing lung, so as to two poor lungs being obvious, the lung is obvious under the left particularly, there are less lung sharp department pathological changes, dual side pleuras are increased thick, the mediastinal lymph node is not swelling. Pass the intersection of ammonia and the intersection of benzyl and penicillin + easy the intersection of Batan and sodium admitted to hospital, ' Triumphant and blue and happy) And left oxygen Fluorine sand star resists inflammation and treats 12d, beautiful Luo banks up the south with earth and resists inflammation and treats 4d, and relieve cough, reduce phlegm, support to treat, cough and expectoration symptom lighten, yellow phlegm disappears, the body temperature fluctuates among 37.5 38.8 straight, abdominal distension and a pair of lower extremities edema appear on February 26, through losing albumin and diuresis treatment, edema of lower extremities disappears and takes off to some extent, there is abdominal distension. Belly Ultrasonography B: Can be seen in the free dark district of liquid in the abdominal cavity, can be seen into a low echo tubercle of bunch behind the peritoneum, the larger one 62m m * 42m m, clear in the border, shape abnormality, along the conduct of walking of trunk, the spleen of liver is not big. Appear enlargement of lymph nodes at the clavicular Left deviation March 6. Walk March 10 lymph node examine while being living at the clavicular left, postoperative pathologic histology and immune group it turns report into persons who fill the air to be the intersection of Hodgkin and malignant lymphoma (the intersection of B and cell type, cells are medium-sized to split up) .
Discussion
Alveolus albumen it deposits diseases to be one rare the intersection of lung and disease of filling the air etc., characteristic its to accumulate P A S, dye the intersection of masculine gender and rich material, - like of albumen, of lipid in the alveolus, the cause of disease is not clear, think it may be that the specificity react with sucking the lung that the physical and chemical material causes at present, immune system obstacle, unidentified toxic material make lung cysticercus of penetrating increase of blood vessel of lung, card infect and have something to do, continue, send, remove function, damage, use the intersection of glucocorticoid and the intersection of immunological function and low or the intersection of blood and systematic patient of malignant tumour on lung often. The clinical characteristic, for going on dyspnea, hypoxemia disease, some patients present pokes to point the toe) ,Serious disease can be cyanosis and lung artery high pressure. About 20% 25% of the patients die in 5 years. The chest X-ray is shown as the filling the air tiny tubercle shadow, the content of enzyme lactic dehydrogenase of serum increases, but there is no specificity. The intersection of diagnosis and main the intersection of basis and bronchus of P A P alveolus irritate, wash and by fine to prop up the intersection of mirror and lung, live, examine, pathology can be seen and full of not finalizing the design in the alveolus protein, passes the snow of iodine and dyes and reflects the masculine gender (P A S) ,Is dyed(A B) hard and bluely Negative, has not radically treated the method yet at home at present, adopt the alveolus to irritate and wash and make the good result abroad, there are also few reports of our country. Employ the bronchus alveolus to have obvious improvement to treat the patient's pathological change, clinical symptom and lung function to wash the law to irritate in recent years.
Lymphoma originated from the lymph node and formed malignant tumour of the immune system of the other lymphoid tissue, usually grow in the form of entity tumour, his characteristic's clinical manifestation is the painless going on enlargement of lymph nodes, can with generating heat, become thin, night sweat,etc. whole body symptom,there are getting getting getting clearer more more totally still in cause of disease on its. May relate to the fact that the virus is infected. Decline of immunological function of patient can bring out emergence of lymphoma, find heredity or the intersection of acquired character and the intersection of immunity and defective patient accompany person who takes place lymphoma to be than normal people large in recent years. This patient made a definite diagnosis of and deposited disease for the alveolus albumen 5 years ago, this disease and immune obstacle had close relationed that perhaps because infected repeatedly, in addition, use glucocorticoid in the other institute many times, make organism resistance lower, the decline of immunity may be a foundation of suffering from lymphoma. But not seen the report that P A P amalgamated lymphoma yet at home at present, the precise relation of the two is still indeterminate. Get up the intersection of disease and the intersection of future trouble person and low-heat this time, make a definite diagnosis of, deposit disease for the intersection of alveolus and albumen previously, fill the cooking stove of venereal disease on C T and chest block, and the mediastinal lymph node is not big, the phlegm trains bacterium and exists, so only consider depositing disease and lung to infect for the alveolus albumen when admitted to hospital, and not considered amalgamating possibility of lymphoma, it is quick according to medicine but pass many kinds of strong antibiotic) The therapeutic effect is not good, the enlargement of lymph nodes behind the belly Ultrasonography B finds the peritoneum, and then it is clavicular to present and have the enlargement of lymph nodes, so made us make pathology and organize the inspection, verified the diagnosis of lymphoma to it finally.
|