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yxfbbiedtj · Wysłany: Pią 10:08, 04 Mar 2011

Misdiagnosed as angina, chest pain

Diagnostic difficulties caused great division, a high rate of misdiagnosis. 2.1 Results aim Feng misdiagnosed as 40% of the group. Meningeal carcinoma (sF change except increased outside pressure, CSF cells and protein can be increased, decreased sugar chloride, similar to such change and tuberculosis. This group of 6 cases of F cells,[link widoczny dla zalogowanych], were slightly elevated protein, glucose,[link widoczny dla zalogowanych], chlorides reduced , the anti-tuberculosis treatment of exacerbations, transferred cytology in our hospital found that too stalk F {i} cells and confirmed. 2,2 Feng Group 4 down misdiagnosed as viral meningitis, meningeal irritation were West of Il 『j , CSF cell count is not high. protein, sugar, chlorides normal, with only a headache, mild irritability l spring. mental disorder, the anti-inflammatory, antiviral treatment is invalid, after the review of CsF, cytological examination revealed a large number of concurrent cancer cells and confirmed. 2.3 HSBC Group 2 cases were misdiagnosed as cerebral infarction, because the first MRI showed bilateral basal ganglia, frontal lobe, 66l multiple small low density lesions on the left thalamus, the line diffuser, improve blood viscosity and other treatment, headache, confusion, progressive increase, CSF cytology is not found in cancer cells, lung right lower lung scan cT peripheral lung cancer, breast skull plain film see the pillow around, scrambling the cockroach before bone density increased tuberosity, cranial plate scattered light film of varying sizes, indicating that skull metastasis of lung cancer, and confirm the diagnosis. 2.4 2 cases misdiagnosed as sciatica are due to lumbosacral and right leg pain as the first symptom, headache, consciousness change is not obvious, the indomethacin, partially closed and so on. symptoms, light weight, getting headaches, vomiting, hospitalization. cT no abnormal skull and spine, CSF cytology examination revealed a large number of cancer cells and confirmed. male and 1 down for the older men, lung cancer surgery 2 more than a year, because there apathy reaction retardation, mental disorder six months, the first line of Cr examination no abnormalities, suspected dementia,[link widoczny dla zalogowanych], application of brain cell protective agent, promoting blood circulation of cancer and other treatment, his condition gradually worsened headache, vomiting, OK (examination revealed The diagnosis of a large number of cancer cases were misdiagnosed in this group l5 experience made us realize that the main way meningeal metastasis: ① transferred to the blood and of spinal leptomeningeal Mu; ② transferred to the choroid plexus blood vessels and making subarachnoid cavity; ③ such spirit by retrograde lymphatic spread around; ④ transferred to 13otS ~ rt Rita Zha dural venous plexus of the inferior vena; ⑤ lift perivascular concentric tube set lymph spread; ⑥ be transferred to the skull, meninges and then violated. Clinical manifestations : headache, vomiting, stiff neck, coma, drowsiness, seizures; easy to damage Ⅲ ~ Ⅷ cranial nerves, spinal nerve symptoms are common, such as neck pain, lumbar pain and radiation to both lower extremities, pain in the limbs associated with paresthesias; psychiatric symptoms: such as apathy, unresponsive, restlessness, hallucinations, confusion,[link widoczny dla zalogowanych], dementia, etc. I understand the clinical case of meningeal cancer should be alert to the following conditions: ① in the elderly with headache, vomiting, cranial nerve palsy as the first symptom, and CT and MR head no exception; ② suspected tuberculous meningitis or viral meningitis such as tuberculosis or anti-virus ineffective governance boil; ③ to the spinal nerve symptoms as the first,[link widoczny dla zalogowanych], after the headache, nausea, vomiting and progressive increase persons; ④ in malignant tumors for several years after surgery, mental, behavioral abnormalities, the need for timely repeated line CSF cytology. because, C cytologic diagnosis of cancer found in cancer cells is the main basis meninges, the detection rate as high as hesitant % to 90%.