's general knowledge of diagnosis of tubercle

's general knowledge of diagnosis of tubercle
1,Diagnostic standard and basis
The diagnosis main basis clinical manifestation of tubercle, pathological evidence, and after getting rid of other granulation swollen diseases, can diagnose. Chinese Medical Association breathe disease learn the intersection of tubercle and disease study group, carry on the 3rd revision to clinic and pathological diagnosis, tubercle of disease 1993, the diagnostic standard is as follows.
(1)Clinical diagnostic standard: The chest block reveals one pair of sides lung door and mediastinal symmetrical enlargement of lymph nodes (the accidental single enlargement of lymph nodes of side lung door) ,Accompany or not with netted, tubercle, flaky shade in the lung. Consult the chest CT to carry on by stages if necessary. It verifies or accords with tubercle (note to organize examining alive: The position is a swelling simple table lymph node to draw materials, in it is swelling it is mediastinal for lymph node, bronchus tubercle of membrane, before lymph node and liver puncture or lung be examined,etc. to be lived oblique angle skin cushions fat) . Kveim tests the positive reaction. Serum angiotensin changes enzyme (SACE) The activity rises (accept the hormone treatment or tubercle patient without activity in the normal range) . It is the negative or weak positive reaction that 5TU PPD-S tests 5TU tuberculin test. High blood calcium, high urine, alkaline phosphatase increases, immunoglobulin (Ig) of blood plasma increases, the bronchus alveolus is irritated in lotion T lymphocytes and the inferior inspection result of group are waited for and can be regarded as the reference which diagnoses the activity of tubercle. Can be made when there are conditions. After 67Ga nuclide is injected, employ SPECT to show the picture or take pictures, in order to understand intensity and range that pathological change infringes.
Have Or One person can diagnose as tubercle. (used before numerals to form ordinal numbers) One is important reference index. Pay attention to judging synthetically, observing dynamically.
(2)Pathologic diagnostic standard: The pathologic change of tubercle lacks the specificity, therefore pathological diagnosis must be combined clinically. The following characteristics support the pathological diagnosis of tubercle. Pathological change mainly for at that cell make up granulation is swollen tubercle in skin kind,there are getting less relatively in volume on tubercle, all kinds of shape is more unanimous, the edge knows. There is not a kind of necrosis of cheese in tubercle, there is cellulose a kind of necrosis of special mess nature in the centre of accidental tubercle. At tubercle it is many to be have core afterbirths big and small often and it come loose on a small quantity in lymphocyte. More lymphocytes are soaked around, wrap up to move round the fibrous tissue on later stage, tubercle can be merged each other a long time, but usually still keep the original tubercle outline. Forgive thing Schumann (Schaumann) in the big and small afterbirth Small body, pair refract light crystalline star probability of body relatively the intersection of tuberculosis and tubercle as more, especially more the intersection of Schumann and little body, lean towards under the mere microscope seeing more pair refract light tubercle, brief tubercle on disease. And tubercle has a large amount of netted fibrous hyperplasia around. Dye and has not seen the tuberculosis fungus (many visual field inspections of oil mirror) specially Or pathogenic microbe such as the fungi. Small blood vessel of very accidental thin wall in tubercle.
(3)The diagnosis term of tubercle:
According to the histologic characteristic of pathology, the diagnosis term combining the clinical materials and considering the following 3 situations.
Diagnose as tubercle: Pathologic finding model, the clinical feature is typical too.
Do not get rid of other tubercle: For swollen pathological change of the granulation, the pathologic characteristic is not typical, clinical manifestation model or not typical.
One kind of responses of locality tubercle: Basically accord with tubercle on histology, but there are other already clear diseases at the same time, for instance: Malignant tumour,etc..
Granulation swollen disease not clear of the mechanism that tubercle a kind of cause of disease and has illness coming on. Clinical manifestation is different and behaving differently according to organs given much trouble. The focal point diagnosed lies in getting rid of other diseases. Chest slice, serum ACE level and biopsy are main means to diagnose tubercle. The range, position are helpful that 67Ga nuclide scans to finding pathological change in early days.
[1]' >Next page
|