Chapter 2716 Stones in the Lungs

"It looks a bit blurry here, like a solid image." Zhao Wenhua said, "Boss Zheng, do you think it's a tumor?"

Zhao Wenhua was stunned for a moment. It was a typical imaging data. I just asked Boss Zheng to take a look for some small thoughts. Why did he not seem to mean it?

Larger mass-like consolidation in the lingual lobe, associated with lobar collapse, left hilar and subcarina lymphadenopathy. Zhao Wenhua took another careful look at the film, ruled out anything he had missed, and then nodded after making sure again.

Hearing the word tumor, the young man next to him felt a little weak in his legs and panicked.

"It's not a tumor." Zheng Ren said, "Be careful...it's a pity that there is only one X-ray. The image density here is different from that of a tumor, and it is higher. Do you think it looks a bit like bone?"

Zhao Wenhua looked at the image of white flowers, trying to find places with different densities.

But he couldn't do it.

Normally speaking, when encountering similar patients in the outpatient clinic, Zhao Wenhua should ask the patient to do a plain CT scan of the lungs, and then find the problem, and then do a 64-slice CT three-dimensional reconstruction.

Gradually increase the intensity of the inspection and you will find the problem.

Boss Zheng's film reading ability is countless times stronger than Zhao Wenhua's, especially the reconstruction ability is fully reflected here. From the video of Bai Huahua, Zheng Ren could see the problem, but Zhao Wenhua couldn't.

"doctor……"

"Professor Zheng." Zhao Wenhua said slightly harshly.

"Oh, oh, Professor Zheng, what do you mean? My dad's lung cancer isn't it." The patient's son asked.

Zheng Ren shook his head and said, "It doesn't look like lung cancer. Based on the medical history you mentioned, I think it's airway stones."

"Stones? Isn't there a stone in the kidney?" the patient's son asked in a daze.

All he knew was kidney stones, and if he recalled carefully, he seemed to be able to recall gallstones too. But the airway stone was too unfamiliar to him, and he couldn't understand what Zheng Ren was saying.

"Emmm, that's it." Zheng Ren pointed at the film reader with the pen in his hand, "Accurately speaking, it should be called bronchial calculus, and it tends to occur on the right side. But your old man's is quite special, it's on the left side. Bronchiolithiasis, also known as calculus, refers to the occurrence of calcified or ossified components in the bronchial lumen or bronchial wall, and is a relatively rare clinical disease."

"Cough stones? Cough out stones?" The patient's son found it difficult to imagine that scene.

"Yeah." Zheng Ren nodded, and said, "Many people don't pay attention to the stones when they cough up, and they don't think about the stones growing in the trachea, so this kind of disease is usually discovered by clinical examination. .”

"Uh... there are stones in the lungs, can you understand this, big...Professor Zheng." The patient's son asked.

"You can say that." Zheng Ren said.

"How did that come about? Is it just such a long stone?" The patient's son still refused to believe it. He used his own logic to judge that it was impossible. If Zhao Wenhua hadn't been by his side, showing his respect and trust to the young Professor Zheng, he would have been popular long ago.

"There are several sources. The first is that foreign bodies in the airway attract or infection secretions form the core of the stones, and the periphery is deposited with calcium salts to gradually form stones. Simply put, it is caused by some kind of foreign body in the respiratory tract, which is more typical. It's the kind of little flying insect that sucks into the airway."

"The second is the formation of hilar lymph node calcification or intrapulmonary calcification that erodes the bronchi and enters the bronchial lumen, which is the most common clinical phenomenon. But I see images, it should not come from this way."

"The third more common possibility is that the cricoid cartilage of the trachea is detached..."

"Professor Zheng, do you mean that the bone fell off?" The patient's son thought about it with his own understanding, and was terrified.

"You can say that, but it's different from what you think." Zheng Ren pointed at a small spot on his left upper lung and said, "From this point of view, your father should have suffered from tuberculosis before."

"..." The patient's son looked blank.

Now tuberculosis is not like it was more than a hundred years ago. Many people don't even notice it when they get it, and then they recover on their own.

Even the patient himself did not know that he was still a tuberculosis patient.

This is very common in clinical practice, and Zheng Ren didn't think there was anything wrong with it.

He briefly explained to the family members of the patients how the tuberculosis bacteria act on the tracheal cartilage, causing the cartilage to fall off and causing bronchial stones.

In fact, Zheng Ren mainly told Zhao Wenhua.

"I won't give you details if it's too specific." Zheng Ren said, "Go home and take your father to the nearest larger hospital."

After hesitating for a while, Zheng Ren continued, "At least it's a city-level tertiary hospital. Let's go to the provincial capital. It's rare to see this disease in a city-level tertiary hospital."

The patient's son wanted to ask something again, but was bumped by Zhao Wenhua, and swallowed the rest of the words.

"Boss Zheng, I'll make arrangements for that. What kind of examination do you want? Bronchoscopy to remove stones?" Zhao Wenhua asked.

"Well, find a doctor with more experience. If the bronchial stones are not handled properly, the complications will still be serious." Zheng Ren said, "Just don't worry, I don't think it's lung cancer."

Zheng Ren's last words reassured the patient's son. He cheerfully took the film and thanked Zhao Wenhua, then turned and left.

Zhao Wenhua wanted to stop him, but Boss Zheng, who was watching the film, didn't even say thank you, how could he be so rude.

But his reaction was a little slow, and the patient's son had already left happily.

"Professor Zhao, you thought it was lung cancer at first." Zheng Ren asked with a smile.

Zhao Wenhua was already discouraged when he faced Boss Zheng, and he was completely unable to be competitive. He said honestly, "Well, I see high-density shadows in the inflammation shadow of the left lower lung, with irregular edges and burrs. I think It's lung cancer."

"Then why did you ask me to take a look?" Zheng Ren sat back on his seat, picked up the red thread and began to weave the red rope.

"Because there was hemoptysis, blood stasis, and blood clots may block the bronchi, forming a high-density shadow, covering the shadow of bronchial stones, and it is very easy to be misdiagnosed as lung cancer. I was not sure. I originally wanted my classmate to go for a CT scan. , but didn't I see you?" Zhao Wenhua said with a smile.

Zheng Ren was weaving the red rope, and didn't think too deeply about it. Zhao Wenhua always says half of his speech and hides half of it. Did you see yourself? Should not be the case. He came back from the outpatient clinic with the film, and normally he came here for himself.

Maybe it was because I was not sure what was going on, so I asked myself to take a look. But thinking about these things was tiring, Zheng Ren didn't want to think about it, and continued to weave the red rope.

"Oh, that's right." Zheng Ren thought of something, and said to Zhao Wenhua: "Because it's been a long time, there is granulation tissue hyperplasia, and it is easy to be misdiagnosed as a neoplasm under the bronchoscope. At this time, a biopsy is required first, and then the tumor is ruled out. Stone removal treatment”

"Aren't you diagnosed?" Zhao Wenhua asked a little puzzled.

"I just glanced at it and had some thoughts, so I can't say it's a diagnosis. The only thing that can be diagnosed is pathology, and it's all guesswork after watching the film." Zheng Ren said.