Chapter 2717 Stones in the lungs
“It’s a little blurry here, like a real image. ” “Boss Zheng, you think it’s a tumor, right?” Zhao Wenhua asked.
Zhao Wenhua was stunned for a moment. It was a typical medical imaging material. He had only asked boss Zheng to take a look because of some small ideas. Why did it sound like that was not the case?
A large tumor-like solid change in the lobular lung, related to the collapse of the lobular lung, and swollen lymph nodes under the left lung gate and tracheal protrusion. Zhao Wenhua took a closer look at the film and confirmed that he had missed out on something. He nodded after he confirmed it again.
Hearing the word “tumor,” the young man’s legs went soft and he panicked.
“It’s not a tumor,” Zheng Ren said,”look carefully … Unfortunately, there’s only one X-ray scan. The image density here is different from that of the tumor. It’s higher. Don’t you think it’s similar to bone?”
Zhao Wenhua looked at the White image and tried to find the difference in density.
But he couldn’t do it.
Under normal circumstances, when he encountered a similar patient in the outpatient department, Zhao Wenhua would let the patient do a flat CT scan of the lungs. Then, if he found a problem, he would do a 64-row CT three-dimensional reconstruction.
The problem would be discovered after the intensity of the examination was increased.
Boss Zheng’s ability to read films was many times better than Zhao Wenhua ‘s, especially his ability to rebuild films. Zheng Ren could see the problem from the White video, but Zhao Wenhua could not.
“Doctor …”
“Professor Zheng.” Zhao Wenhua said sternly.
“Oh, oh, professor Zheng, what did you say? My dad doesn’t have lung cancer, does he?” The patient’s son asked.
Zheng Ren shook his head and said,”it doesn’t look like lung cancer. Combined with the medical history you mentioned, I think it’s a stone in the airway.”
“Gallstones? Isn’t there a stone in your kidney?” The patient’s son asked in a daze.
He only knew about kidney stones, but if he tried to recall, he could also remember gallstones. However, he was too unfamiliar with respiratory tract stones to understand what Zheng Ren was saying.
“ERM, it’s like this.” Zheng Ren used the pen in his hand to point at the film reader.”To be precise, it’s called bronchilostallion, and it happens on the right side. But your old man’s is a bit special, it’s on the left. “Bronchilosis is also known as stroke. It refers to the appearance of calcified or bony components in the bronchilosis or the walls of the trachea. It’s a relatively rare clinical disease.”
“Falling stone? Coughing out rocks?” The patient’s son found it hard to imagine such a scene.
“Yes.” Zheng Ren nodded.”A lot of people don’t pay attention when they cough out stones. They don’t think about the stones that grow in their trachea either. So, this disease is generally discovered through clinical tests.”
“Uh … There’s a rock in my lungs. Can you understand it that way, big … Professor Zheng?” The patient’s son asked.
“You can say that.” Zheng Ren said.
“How did that come about? It’s already this long?” The patient’s son still refused to believe it. He used his own logic to judge that this was impossible. If it wasn’t for the fact that Zhao Wenhua was right next to him, showing his respect and trust for this young professor Zheng, he would’ve been on fire.
“There are a few sources. First, the attraction of foreign objects in the airway or the infection of secretions form the core of the stone. The periphery is gradually formed by the deposit of calcium salt. To put it simply, it’s caused by a foreign object entering the respiratory tract. A more typical example is the small bug that was inhaled into the respiratory tract. “
“The second is the calcification of the hepatic lymph nodes or the calcification in the lungs that erodes the bronchi and enters the bronchi cavity. It’s the most common in clinical practice. But from the video, it shouldn’t have come from that. “
“The third and more common possibility is that the cricoid cartilage in the trachea has fallen off …”
“Professor Zheng, are you saying that the bone fell off?” The patient’s son used his own understanding to think about it, and it was extremely terrifying when he thought about it.
“You can say that, but it’s not what you think.” Zheng Ren pointed at a small spot on his left upper lung and said,”from this, your father should have had tuberculosis before.”
The patient’s son looked confused.
Tuberculosis was no longer the same as it was a hundred years ago. Many people would not even notice it when they got it, and then it would heal itself.
The patient did not even know that he was a tuberculosis patient.
This was common in clinical medicine, so Zheng Ren did not think much of it.
He briefly explained to the patient’s family how the tuberculosis bacteria acted on the mechanism of action on the tracheal cartilage, causing the cartilage to fall off and cause pulmonary gallstones.
In fact, Zheng Ren was mainly saying it for Zhao Wenhua to hear.
“I won’t go into the details.” Zheng Ren said,”go home and bring your father to the nearest hospital that’s a little bigger.”
After hesitating for a while, Zheng Ren continued,””At least a city-level tertiary Grade A hospital. Let’s go to the provincial capital. This disease is rare even in a city-level tertiary Grade A hospital.”
The patient’s son wanted to ask something else, but Zhao Wenhua bumped into him, and he swallowed the rest of his words.
“Boss Zheng, I’ll make the arrangements. What kind of examination do you want to do? Tracheostomy to remove gallstones?” Zhao Wenhua asked.
“Yes, find an experienced doctor to get it. If you don’t operate the patient properly, there will be severe complications. ” Zheng Ren said,”don’t worry, I’m thinking it’s not lung cancer.”
Zheng Ren’s last sentence made the patient’s son feel at ease. He happily took the scan and thanked Zhao Wenhua before he turned around 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?
However, 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, didn’t you?” Zheng Ren asked with a smile.
Zhao Wenhua was already discouraged when he faced boss Zheng. He did not have any competitive spirit at all. He told the truth,”yes, I saw a high-density shadow in the inflamed shadow of the left lower lung. The edges are irregular and there are bristles. I think it’s lung cancer.”
“Then why did you ask me to take a look?” Zheng Ren returned to his seat and picked up the red string to start weaving a red rope.
“Because of the previous giggle and blood clots, blood clots may cause blockage of the bronchi, forming a high-density shadow, covering the stone shadow of the bronchi. It is very easy to be misdiagnosed as lung cancer. I’m not sure, and I wanted my classmate to do a CT scan, but I saw you here. ” Zhao Wenhua laughed.
Zheng Ren was weaving the red rope and didn’t think too much about it. Zhao Wenhua always spoke in between. Did he see me? That shouldn’t be the case. Normally, he came back from the clinic with the X-ray film for her.
Maybe he was not sure what was going on, so he asked her to take a look. However, these careful thoughts were tiring. Zheng Ren did not want to think too much about it and continued to weave the red rope.
“Oh, that’s right,” Zheng Ren recalled something and said to Zhao Wenhua,””Because it took a long time, there is granulation tissue hyperplasia, and it is easy to be misdiagnosed as a new organism by a tracheostomy tube. At that time, we’ll need to do a biopsy to remove the tumor before we can remove the gallstones. “
“Didn’t you make a definite diagnosis?” Zhao Wenhua asked in confusion.
“I just took a look and had some thoughts, but I can’t be sure. Only pathology can make a definite diagnosis. We can only guess when we look at the scans. ” Zheng Ren said.