结核合并结节性脂膜炎一例报告

Case report of tuberculsos with panniculitis

患者,女22岁,农民。咳白粉痰,间断少量痰血,伴乏力、气短二月余,95年2月13日摄胸片和CT片发现右上纵膈增宽,右上斑点状渗出病灶。1∶2000P.P.D试验强阳性,拟诊肺结核于95年2月20日开始行H.R.S.E四化抗痨治疗。因抗痨一周后患者出现持续不规则发热38-39℃,随之出现右侧颈部肿块而来院。在某专科医院,曾作颈部肿块穿刺,病理报告:炎症样组织,结核可能性大。

The patients is a 22 years old femal peasant. She had cough, a little blood-tinged sputum, short breath and symptoms of superior vena cave syndrome. The X - ray and CT films demonstrated broadening of right upper mediastinum and mottling in the right upper lung lobe. PPD test was a strong positive. She was diagnosed as pulmonary tuberculosis and was given H. R. S. E. to treat TB infection. But she still had constant fever(38 to 39℃ Muring the period of treatment. Three months later the symtoms of superior vena cava syndrome disappeared, but congestive lumps were found in the area of neek,face and right upper arm. The biopsy implied liparoid vasalium. The obvious enlarging of right upper mediastinum disappeared in the chest films taken later,but the focus in the right upper lung worsened. The combinative diagnosis of panniculitis was considered. After treatment of anti-TB drug and prednisonem.the patient's condition was controlled. The prognosis was good.