Combined with the CT film on October 20, 2021, it is shown that: 1. There are scattered nodules, masses and patchy shadows in both lungs. Now, the large mass is located in the anterior basal segment of the lower lobe of the right lung, with a length and diameter of about 3.1cm, which shows the air containing bronchus; The anterior segment of the upper lobe of the right lung shows a small cavity with thick wall, with a length and diameter of about 11mm. The patch shadow of the anterior segment presents the "snowflake sign"; Considering the possibility of secondary pulmonary tuberculosis, it is not excluded that it is complicated with neoplastic lesions; Compared with before, the lesions in the posterior basal segment of the lower lobe of the right lung were smaller than before, and most of the other lesions were larger than before; It is recommended to recheck after treatment in a short time. 2. Diffuse miliary nodules in both lungs. It is recommended to analyze whether there is an occupational history of dust exposure in combination with clinical practice. 3 Calcification of aortic arch, descending thoracic aorta and left and right coronary artery walls; A small amount of pericardial effusion is absorbed less than before. It's been a month, everything has been checked, but there's still no diagnosis. It's hard for experts to help. I'm at a loss!
The diagnosis of tuberculosis requires pathology, or a gene sequencing. Tuberculosis infection can be found, and sputum culture can be done repeatedly. Pathology is a gold standard. In combination with clinical symptoms, it is most important to clarify the etiology for treatment,
The examination report shows multiple pulmonary nodules with patchy shadow, which does not rule out the possibility of tumor. The DNA result of Mycobacterium tuberculosis complex group is not detected, which can rule out pulmonary tuberculosis. It is suggested that the presence of tumor can be determined by combining the results of bronchoscopy and pathology.
It is unlikely that tuberculosis should be seen in the inspection report. Do you have obvious symptoms now? If there are no obvious symptoms, you can correct the bad habits in life, keep warm and pay attention to adjusting the rules of life. If there are obvious symptoms, you can carry out specific treatment according to the specific symptoms.
From the perspective of imaging, it is more likely to engage in tuberculosis, but sometimes it is difficult to find tuberculosis bacteria in sputum examination of many patients with tuberculosis, because the combination itself is long and deep. Therefore, theoretically speaking, from the perspective of disease diagnosis, I personally consider the possibility of tuberculosis
If you directly find TB bacteria in sputum, you can directly diagnose pulmonary tuberculosis. There are many kinds of diagnosis of pulmonary tuberculosis. Test results and imaging can be assisted, such as PPD test, ESR and tspot. You can check a T-SPOT