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LUF 差点被误诊为卵巢癌 LUF was almost misdiagnosed as ovarian cancer, 2008-9-20.

  • 来源:cfl
  • 作者:cfl
  • 更新日期:2019-07-19 21:22
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卢女士,48岁,现病史:2008年6月9日患者无明显诱因出现发热、排尿时下腹痛,在当地医院查尿常规:红细胞++,血常规:白细胞偏高,当地医院诊断泌尿系感染,行输液抗炎治疗后好转;2008年8月20日患者又出现发热、排尿时下腹痛症状,在当地医院测体温:39度,

卢女士,48岁,现病史:2008年6月9日患者无明显诱因出现发热、排尿时下腹痛,在当地医院查“尿常规:红细胞++,血常规:白细胞偏高”,当地医院诊断“泌尿系感染”,行输液抗炎治疗后好转;2008年8月20日患者又出现发热、排尿时下腹痛症状,在当地医院测体温:39度,查“尿常规:红细胞++”,予安痛定肌注后仍未退热,后用高效退热药及抗炎治疗7天后好转(具体用药不详);2008年9月13日患者在当地医院查彩超示:“盆腔肿物囊实相间7cm,性质待查”;伴随左下腹胀痛,腰部偶有牵扯痛,伴大便感。FSH 0.316mIU/ml LH 0.930 ,mIU/ml ,E2 122 TESTO,84.28ng/dl,PRL 2.56ng/ml PROG 8.60 。所有肿瘤标记物均为阴性。

Mrs. Lu, 48, current history: on June 9, 2008, the patient had no obvious cause for fever and abdominal pain when urinating. In the local hospital, she checked "urinary routine: red blood cell + +, blood routine: high white blood cells", and the local hospital diagnosed "urinary tract infection." After the infusion anti-inflammatory treatment improved; On August 20, 2008, the patient developed symptoms of abdominal pain during fever and urination. Body temperature was measured at 39 degrees in the local hospital. The "urine routine: red blood cell + +" was checked. After the injection of Antongding muscle, it still did not regress. After 7 days of treatment with highly effective antipyretic drugs and anti-inflammatory treatment, it improved(specific medication is unknown); On September 13, 2008, the patient was examined at the local hospital: "The pelvic masses are actually 7cm in size, and their properties are to be investigated"; Accompanied by distended pain in the lower left abdomen, occasionally involving pain in the waist, accompanied by a feeling of stool. FSH 0.316 mIU/ml LH 0.930, mIU/ml, E2 122 TESTO, 84.28 ng/dl, PRL 2.56 ng/ml PROG 8.60. All tumor markers are negative.

怀疑卵巢癌,依据有1.更年期年龄;2.盆腔包快生长迅速;3.B超提示肿物囊实相间超过4cm。

Suspected ovarian cancer, based on 1. Menopause age; 2. The pelvic bag grows rapidly and rapidly; 3. B Super prompt the swelling capsule is actually more than 4cm.

2008年9月20日安太医院腹腔镜探查:左卵巢囊肿,直径7cm,暗紫色,与左侧输卵管、左侧盆壁、肠管、大网膜结缔组织性粘连,操作:腹腔镜下穿刺左卵巢囊肿,抽出囊内液20ml送细胞学检查,液体为血性。松解左输卵管、卵巢与周围组织的粘连。细胞学检查结果回报为白细胞、红细胞,未见肿瘤细胞。完整剥除囊肿壁,囊肿壁为黄体组织,考虑左卵巢囊肿为黄体囊肿合并出血,3-0可吸收线连续缝合左卵巢成形。

September 20, 2008 Antai Hospital Laparoscopic exploration: Left ovarian cyst, 7cm in diameter, dark purple, organizational adhesion with the left fallopian tube, left pelvic wall, intestinal duct, and large omentum, operation: laparoscopic puncture of left ovarian cyst, Extraction intracystic fluid 20ml send cytology examination, liquid is bloody. Loosen the adhesion of the left fallopian tube and ovary to the surrounding tissue. The results of cytology showed that white blood cells and red blood cells had no tumor cells. The cystic wall is completely exfoliated. The cystic wall is a luteal tissue. After considering the left ovarian cyst as a luteal cyst and bleeding, the 3-0 absorbable line is continuously sutured to the left ovary.

术后诊断:卵泡黄素化不破裂综合征(LUF)

Postoperative diagnosis: follicular yellowing non-rupture syndrome(LUF)

讨论:术前根据年龄和生长速度高度怀疑卵巢癌,术中确是卵泡黄素化不破裂综合征,这个现象在更年期妇女尤其明显,卵巢肿物虽然大于7cm,B超虽然提示囊实相间,仍是生理性的囊肿,实性部分就是血体。可以通过介入治疗的。

Discussion: Preoperative ovarian cancer is highly suspected based on age and growth rate. During surgery, it is indeed follicular yellowing non-rupture syndrome. This phenomenon is particularly evident in menopausal women. Although ovarian masses are greater than 7cm, B-ultrasound indicates that the capsule is real. It is still a physiological cyst. The real part is the blood body. It can be treated through intervention.

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