The diagnosis of tubercle and _'s symptom of the differential diagnosis

The diagnosis of tubercle and _'s symptom of the differential diagnosis
[Diagnose ]
The diagnosis of tubercle is decided by clinical symptom and physical sign and organizes examining alive, other granulation swollen diseases except combining. Its diagnostic standard is summed up: It is symmetrical and swelling that the chest image learns to check and reveal one pair of sides lung door and mediastinal lymph node, accompany or not with the grid, tubercle or flaky shade in the lung; Histology examine, verify, it has to be the intersection of cheese nature and necrosis swollen granulation while being living, resist acid, dye negative; SACE or SL activity increases; It is sIL-2r high in serum or BALF; Old tuberculin (OT) Or PPD tests the masculine gender or weak and positive; Lymphocyte under BALF> 10%, and CD4 + CD8 + ratio is greater than or equal to 3; High blood calcium, high urine; Kveim tests the masculine gender; Except tuberculosis or others is swollen in granulation for disease. In the above-mentioned nine conditions, It is the essential condition, the others are secondary conditions.
[Differential diagnosis ]
Should distinguish with the following diseases:
First, lung door scrofula
Have younger patients and how under 20 years oldly, have the intersection of minuent and toxic symptom, more for being positive tuberculin test often, the enlargement of lymph nodes of lung door is generally single side, the calcification sometimes. It is obvious the lung has illness coming on in the cooking stove originally.
Second, lymphoma
Common all over symptom is generating heat, becoming thin, anaemia,etc., the pleura is given much trouble, present the thorax and accumulate the liquid, the lymph node is swollen mostly single side or dual sides are asymmetric and swelling in the chest, it is mediastinal to often involve, the eminence plays and mediastinal lymph node. Mediastinal press and can present the superior vena cava and block syndrome. Combining other checking and biopsies can be distinguished.
Third, lung door shifting tumour
The transformation of cancerous swelling all has corresponding symptom and physical sign to the lung door lymph node outside lung cancer and lung, further check and can help and distinguish suspicious sending the cooking stove originally.
Fourth, other granulation swollen diseases
Such as other source alveolus inflammation, beryllium disease, pneumosilicosis, infection, chemical granulation due to the factors being swollen, should distinguish with tubercle, combine the clinical materials and have something to do with and check to analyse and judge synthetically.
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