胸外科casereportppt課件

1、case report,,,Name：guangbo sun Age： 61 years oldSex：male Chief complaint：chest pain for 15 days,History of present illness,We present is a 61-years-old male patient。 During the last half month, he experienced i

2、ntermittent chest pain on the right side without any other symptom. In the last half month, the patient chest pain daily so he decided to get a CT scan of the chest. The chest CT showed a placeholder located in the lo

3、wer lobe of right lung.,Past history,He have underwent Interventional surgery of left coronary artery at our hospital in 2015, now oral aspirin intestinal solution 100milligram qd , atorvastatin 20milligram qd ,

4、metopolol 25milligram qd.,Other,Personal history, marital history and family history ： No specialPhysical examination was normal.,The chest CT 2017.10.17,The chest CT 2017.10.17,Imaging diagnosis,The chest CT scan

5、shows the basal segment bronchial obstruction and a mass high density shadow, about 3.2cm in diameter and some burr on the edge of the lower lobe of right lung.The head and abdomen CT scan showed no any signs of

6、 metastasis.The Imaging diagnosis is considered as malignant tumor of the lower lobe of right lung.,Bone scan 2017.10.23,It found have no any especially signs of bone metastasis in whole body bone imaging 。,Bronc

7、hoscope 2017.10.18,The examination of the bronchi through a bronchoscope shows:The submucosal infiltration and hyperplasia of bronchial tube mouth in the lower lobe of right lung was stenosis。,,Pathological results

8、 2017.10.23,Conventional staining combined with immunochemical staining considered was squamous cell carcinoma 。 Immunohistochemical results：CK5/6(+),CK7(-),ki-67(40%+),NapsinA(-),P40(+) ,page1;TTF-1(-) page

9、2.,Other Supplementary Examination,Pulmonary function test showed(2017.10.17)：Forced expiratory volume in one second(FEV1):2.85LForced vital capacity (FVC):3.66LForced Expiratory Flow Rate(FEF):6.59L/SMaximum Ventila

10、tory Volume (MVV）：110.8L/minForced vital capacity as a percentage of predicted value ( FVCPP)：88.9%,Other Supplementary Examination,Colour Sonography （2017.10.17）：1. Ejection fraction （EF）：61%2. Left ventricular dias

11、tolic dysfunction,Preliminary Diagnosis,1. malignant tumor of the lower lobe of right lung. cT2N1M0 IIB 2.Interventional surgery of left coronary artery,Treatment,1. We decided to have surgical treatment was tha

12、t underwent complete video-thocitscopic (VATS)resection of malignant tumors in the right lower lobe of lung in October 25, 2017。2.we aslo had a hyperthermic perfusion chemotherapy postoperation because of we dis

13、coverd there have many suspicious lymph nodes in the operation 。 The drug used for hyperthermic perfusion was 40 milligram cisplatin and had been successfully treated two times。 Up to now， The patient feels go