Patient male, 39 years old, due to "cough, sputum, fever 3 months with gas, increased 10 days" admission.
Patients with no obvious evidence of 3 months ago, itching, cough, cough little white sticky sputum, mostly dry cough mainly with low fever, body temperature 37.5 ~ 38 ℃, irregular, treatment outside the hospital, chest CT showed right lower lobe and left Lungs scattered in the inflammation, pulmonary nodules, according to "pneumonia" has to cefotiantine, cefuroxime, levofloxacin and cefoperazone sulbactam intravenous anti-infective treatment for 10 days, no significant improvement. To another hospital to check the blood tumor indicators were negative, phlegm to find acid-fast bacilli (-), normal blood and liver function, intravenous anti-infective treatment for two weeks were discharged. 1 month ago, patients with chest CT examination showed two lung lesions than before no absorption, and the emergence of shortness of breath, a small amount of sputum blood, bright red, no chest pain, tuberculosis in our hospital, to cephalosporin, azithromycin anti-infection treatment for two weeks , Chest CT showed lesions increased more than before, for further diagnosis and treatment into the respiratory department.
The patients are middle-aged men, smoking history, is a high risk of lung cancer, and cough, fever, sputum, shortness of breath, weight loss symptoms, lung cancer highly suspicious, a number of elevated blood tumor markers further suggest the possibility of lung cancer. However, patients with severe cough, shortness of breath, should not move, can not be further examination of lung puncture, sputum can only be non-invasive examination of cells. After repeated sputum examination, and finally transferred to the respiratory section after 8 days of sputum found adenocarcinoma cells (a total of 3 times), the final clear lung adenocarcinoma with pulmonary embolism diagnosis.