PMCT辅助诊断弥散性肺结核自发性气胸1例

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Forensic Imaging Pub Date : 2023-09-26 DOI:10.1016/j.fri.2023.200565
G. Gokul , Karthi Vignesh Raj K․ , Abhishek Yadav , Sudhir K. Gupta
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引用次数: 0

摘要

背景世界卫生组织《2021年全球结核病报告》指出,结核病仍然是单一传染源死亡的主要原因之一,仅次于新冠肺炎。肺结核可表现为实质病变、血管病变、纵隔病变、气道病变、胸膜病变和胸壁病变。其中一种表现是继发性自发性肺气肿的发展。病例报告一名32岁男性,被发现躺在床上毫无反应,被送往急诊科,在那里他被宣布死亡。尸检显示两肺弥漫性颗粒状病变,伴有脓性分泌物。肉眼检查未发现明显的肺气肿大泡、实质破裂或肋骨骨折。尸检计算机断层扫描显示左侧单侧自发性张力性肺气肿,大血管和纵隔结构受压。组织病理学检查进一步证实两肺均为播散性肺结核。结论对于临床医生来说,涉及自发性继发性肺气肿的死亡非常罕见,因此法医病理学家处于报告此类发现的首要位置。此外,与传统尸检相比,PMCT在诊断张力性肺气肿和纵隔结构压迫方面发挥着重要作用
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PMCT aided diagnosis of spontaneous pneumothorax in a case of disseminated pulmonary tuberculosis

Background

Tuberculosis remains one of the leading causes of death from a single infectious agent, second only to COVID-19, as stated by WHO Global Tuberculosis Report 2021. Tuberculosis can present as parenchymal lesions, vascular lesions, mediastinal lesions, airway lesions, pleural lesions and chest wall lesions. One such presentation is the development of secondary spontaneous pneumothorax.

Case report

A 32-year-old male, found lying in unresponsive state was taken to Emergency department, where he was declared as brought dead. The autopsy revealed diffuse granular lesions on both lungs with purulent secretions. No evident emphysematous bullae or parenchymal breach or rib fractures were appreciable in macroscopic examination. Post mortem Computed tomography revealed unilateral spontaneous tension pneumothorax on the left side with compression of great vessels and mediastinal structures. Histopathological examination further confirmed disseminated tuberculosis in both lungs.

Conclusion

Deaths involving spontaneous secondary pneumothorax is so rare for clinicians that forensic pathologists are in a prime position for reporting such findings. In addition, PMCT plays an important role in diagnosing tension pneumothorax and the compression of mediastinal structures as compared to the traditional autopsy

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来源期刊
Forensic Imaging
Forensic Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
2.20
自引率
27.30%
发文量
39
期刊最新文献
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