Chapter 2715

"It looks a little fuzzy here, like a real image." Zhao Wenhua said, "boss Zheng, do you think it's a tumor?"

Zhao Wenhua was stunned. It's a typical imaging material. He only looked at boss Zheng for some careful thinking. Why doesn't he mean?

It shows a large mass like consolidation in the tongue lobe of the lung, which is related to the collapse of the lung lobe, and the lymph nodes under the left hilar and tracheal carina are enlarged. Zhao Wenhua took another look at the film carefully, eliminated what he missed, and nodded after he was sure again.

Hearing the word "tumor", the young man next to him felt a little soft and flustered.

"It's not a tumor." Zheng Ren said, "carefully... Unfortunately, there is only one X-ray film. The image density here is different from that of the tumor. It should be higher. Do you think it is a bit like bone?"

Zhao Wenhua looked at the images of white flowers and tried to find places with different densities.

But he can't.

If you normally encounter similar patients in the outpatient department, Zhao Wenhua should ask the patient to do a plain CT scan of the lung, and then find the problem, and then do 64 row CT three-dimensional reconstruction.

The problem will be found after increasing the inspection intensity step by step.

Boss Zheng's film reading ability is countless times stronger than Zhao Wenhua, especially the reconstruction ability is reflected incisively and vividly here. From Bai Huahua's image, Zheng Ren can see the problem, but Zhao Wenhua can't.

"Doctor..."

"My name is Professor Zheng." Zhao Wenhua said slightly sternly.

"Oh, oh, Professor Zheng, what do you say? My father is not lung cancer." Asked the patient's son.

Zheng Ren shook his head and said, "it's not like lung cancer. Combined with your medical history, I think it's airway stones."

"Stone? Isn't there a stone in the kidney?" The patient's son asked in a trance.

All he knows is kidney stones. If he recalls carefully, he seems to remember gallstones. But airway stones were too strange for him to understand what Zheng Ren said.

"Emmm, that's right." Zheng Ren lit the film reader with the tube pen in his hand. "To be exact, it should be called bronchial stone, which often occurs on the right side. But your father's son is special, on the left side. Bronchial stone disease, also known as pyrolithiasis, refers to calcification or ossification in the bronchial cavity or bronchial wall, which is a relatively rare clinical disease."

"Stone? Coughing stone?" The patient's son found it difficult to imagine that picture.

"Yes." Zheng Ren nodded and said, "many people don't pay attention to the stones when they cough, and don't think about the stones growing in the trachea, so this disease is generally found by clinical examination."

"Er... There are stones in my lungs. Can you understand that, Professor Zheng?" Asked the patient's son.

"You can say so." Zheng Rendao.

"How did that come from? It's such a long stone?" The patient's son still refused to believe it. He judged it with his own logic, which is impossible. If Zhao Wenhua had not been around and showed his respect and trust in the young Professor Zheng, he would have been angry.

"There are several sources. The first is that the secretion attracted by foreign bodies in the airway or infected constitutes the core of the stone, and the periphery is deposited by calcium salt to gradually form the stone. In short, it is caused by some foreign bodies in the respiratory tract, and the typical one is that small flying insects suck into the airway."

"The second is hilar lymph node calcification or intrapulmonary calcification, which erodes the bronchus and enters the bronchial lumen. It is most common in clinic. But I think the image should not come like this."

"The third common possibility is that the cricoid cartilage of the trachea falls off..."

"Professor Zheng, do you mean the bone has fallen off?" The patient's son thought about it with his own understanding and thought carefully.

"You can say so, but it's different from what you think." Zheng Ren pointed at a small spot in his left upper lung and said, "here, your father should have had tuberculosis before."

"..." the patient's son looked blankly.

Tuberculosis is not what it was more than 100 years ago. Many people are not aware of it at all, and then they recover themselves.

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

This is very common in clinic, and Zheng Ren doesn't think it's any different.

He simply told his family members about the mechanism of how TB affects the cartilage of the trachea, causing cartilage to fall off and cause broncholithiasis.

In fact, Zheng Ren mainly said it to Zhao Wenhua.

"I won't tell you in detail if it's too specific." Zheng Ren said, "go home and take your father to the nearest bigger hospital."

After hesitating for a while, Zheng Ren continued, "at least it's a municipal grade-3 hospital. It's better to go to the provincial capital. This disease is rare in municipal grade-3 hospitals."

What did the patient's son ask again? He was hit by Zhao Wenhua and swallowed the rest.

"Boss Zheng, I'll arrange that side. What do you say to do? Take stones by tracheoscopy?" Zhao Wenhua asked.

"Well, find an experienced doctor to take it. If the bronchial stone is not handled properly, the complications are still very serious." Zheng Rendao, "don't worry, I think it's not lung cancer."

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

Zhao Wenhua wanted to stop him. Boss Zheng didn't say thank you. How could he be so impolite.

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

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

Zhao Wenhua was discouraged when he faced boss Zheng. He couldn't afford to be competitive. He told the truth, "well, I see that there are high-density shadows, irregular edges and burrs in the inflammatory shadow of the left lower lung. I think it's lung cancer."

"Then why did you look at me?" Zheng Ren returned to his seat, picked up the red thread and began to weave the red rope.

"Because there was hemoptysis, blood stasis and blood clot before, it may block the bronchus, form a high-density shadow and cover up the shadow of bronchial stones, which is very easy to be misdiagnosed as lung cancer. I'm not sure. I wanted my classmates to have a CT, but I didn't see you." Zhao Wenhua smiled.

Zheng Ren made up a red rope and didn't think deeply. Zhao Wenhua always talks half and hides half. Do you see yourself? I don't think so. He came back from the clinic with a film. Normally, he came on his own.

Maybe I wasn't sure what was going on, so I took a look at myself. But these careful thoughts are very tired. Zheng Ren doesn't want to think more and continues to weave the red rope.

"Oh, yes." Zheng Ren thought of something and said to Zhao Wenhua, "because of the long time, granulation tissue hyperplasia, it is easy to be misdiagnosed as a new organism under tracheoscopy. At this time, we need to conduct biopsy first, eliminate the tumor, and then remove the stone."

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

"I just looked at it and had some ideas. I can't say the diagnosis. The only thing that can be diagnosed is pathology. I guess when I watch the film." Zheng Ren said.