Пол пациента:
Тип патологии:
Область исследования:
Пациентка Л, 68 лет. Жалобы на слабость, похудание, субфебрильную температуру, кашель со скудной мокротой, выраженную одышку при ходьбе, повышенную потливость, отечность стоп. Последнее ФЛО в марте 2018 - норма (по записям - снимка нет). Туб. контакт с сыном(более 10 лет назад). Оперирована по поводу cr желудка в 2016, сахарный диабет 2 типа, бронхиальная астма, ГБ 2 ст, мерцательная аритмия.
Рентген
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Рентген ID:78148
Цель публикации:
И все таки за мтс рака желудка с отрицательной динамикой, несмотря на контакт по туберкулезу и сахарный диабет.
+1 Особенно, если там была аденокарцинома.
Все бы ничего, но вот мбт всеми методами выявлены....Думаю что вполне вероятно сочетание двух заболеваний. Бронхоскопия патплогии не выявила. Да, еще забыл написать что со слов пациентки в детстве ставили первичный туб. комплекс.
На вич-инфекцию проверяли?
Вы считаете что туберкулёз при вич-инфекции может дать такую картину?
Диссеминированный тбс
"туберкулёз при вич-инфекции может дать такую картину?" #5. Да, вич-инфекция меняет классическую локализацию туберкулёзного процесса в лёгких.
Да, картина для туберкулеза очень нетипична.
https://vk.com/kotlyarov_andrey
Были ли выявлены МБТ от 18.06.18г, и если нет, то что диагностировали (1)?. Если были выявленны МБТ, то вероятно, лечили( 2)?
Анализ на вич отрицательный. Анализ на МБТ выявлен 12.07.18, на данный момент лечится в тубдиспансере (уже около 1,5 мес).
Т.е. 18.06.18г с этой рентгенограммой она была у онколога. Что говорят онкологи?
да, с этой рентгенограммой и Кт, по которой в заключении пишут что больше данных за mts изменения в легких. Онкологи отправили ее в тубдиспансер, где у нее и взяли анализы на МБТ.
При положительном выявлении МБТ от 12.07.18г как расцениваите динамику рентгенограмм от 17.07.18г и 05.09.18г на фоне спецефического лечения?
При положительном выявлении МБТ от 12.07.18г как расцениваите динамику рентгенограмм от 17.07.18г и 05.09.18г на фоне спецефического лечения?
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Мое мнение, что картина без динамики (снимок от июля сфоткан с пленки).
Да, архив был бы интересен. И не только за март 2018г, но и за 2016г ( без рентгена на опер. лечение не берут), 2017г ( динамическое наблюдение послеоперационного пациентта). Интересно, спасибо, ждем продолжение.