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題名 | Chronic Pulmonary Metastatic Calcification in a Long-Term Hemodialysis Patient: A Case Report=長期血液透析病患發生慢性轉移性肺鈣化--病例報告 |
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作者 | 洪啟超; 朱國安; 盧朝勇; 丁燿明; 洪士元; | 書刊名 | 胸腔醫學 |
卷期 | 14:2 1999.06[民88.06] |
頁次 | 頁82-88 |
分類號 | 415.46 |
關鍵詞 | 肺鈣化; 慢性腎衰竭; 血液透析; Chronic renal failure; Hemodialysis pulmonary calcification; |
語文 | 英文(English) |
中文摘要 | 轉移性肺鈣化是個罕見的疾病,其特徵是肺泡間隔的鈣質沉積,大多 數於慢性透析病人遺體解剖時所發現。此病人胸部X光表現不明顯,通常必須 等到嚴重的呼吸症狀出現時X光才有明顯異常。我們描述一位62歲長期接受血 液透析的男性尿毒症病患。胸部X光顯示兩側多發性小結節。儘管一開始懷疑 粟狀結核病,但是經過一系列胸部X光,高解析度電腦斷層,骨骼掃瞄檢查後, 認為是轉移性肺鈣化。再經由支氣管鏡生檢,確定了轉移性肺鈣化這個診斷。在 此,我們回顧了一些文獻,並且在稍後討論此病的病因、病理機轉、生理、以及 影像學上的特徵。骨骼掃瞄和高解析度胸部電腦斷層通常是診斷上之利器。如果 病人無嚴重的呼吸症狀,以侵犯性檢查來取得病理診斷通常並非必要。 |
英文摘要 | Pulmonary metastatic calcification is a rare disease characterized by calcium deposition in alveolar septa and is mostly found in autopsy of patients receiving chronic hemodialysis. It is often an insignificant finding on chest roentgenography until severe clinical respiratory symptoms appear. We describe a 62 year-old male with chronic hemodialysis for uremia, whose chest roentgenography (CXR) showed multiple visible tiny nodules over bilateral lung fields. Miliary tuberculosis(TB) was suspected at first, but later, pulmonary metastatic calcification was considered after a series of follow up CXR, high resolution computed tomography(HRCT) of chest, and bone scan examination. The diagnosis of pulmonary metastatic calcification was confirmed by bronchoscopic biopsy. Literatures were reviewed, the etiology pathogenesis, physiology and imaging characteristics of pulmonary metastatic calcification were also discussed. Bone scan and HRCT are good diagnostic tools. Invasive study is seldom indicated for pathologic diagnosis if patient does not have severe respiratory symptoms. |
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