History

A 70-year-old woman with a 6-year history of asthma, a 12-year history of diabetes mellitus, and who did not smoke presented to the pulmonology clinic with dyspnea and cough. Chest CT performed 5 years earlier for similar symptoms revealed multiple pulmonary nodules. However, she was lost to follow-up before the work-up was concluded. Otherwise, her medical history was unremarkable. Family history included maternal endometrial cancer. Physical examination revealed partial oxygen saturation of 98%, respiratory rate of 18 breaths per minute, and heart rate of 77 beats per minute. Her breath sounds and other systemic findings were normal. Pulmonary function test results were as follows: forced expiratory volume in 1 second, 108% predicted (normal range, 80%–120%); total lung capacity, 72% predicted (normal range, 80%–120%); forced vital capacity, 101% predicted (normal range, 80%–120%); diffusing capacity for carbon monoxide, 69% predicted (normal range, 60%–120%); and forced midexpiratory flow, 85% predicted (normal range, 40%–160%). Complete blood count, erythrocyte sedimentation rate, C-reactive protein level, rheumatoid factor, and antinuclear antibody levels were within normal limits. The patient underwent volumetric thin-section CT of the chest using a multidetector CT scanner (Ingenuity Core 128; Philips Medical Systems) to evaluate lung nodules and pulmonary interstitium.

中文翻译：

---

病例323：微小肺脑膜上皮样结节

历史

一名 70 岁女性，有 6 年哮喘病史、12 年糖尿病病史，不吸烟，因呼吸困难和咳嗽到肺科诊所就诊。 5 年前因类似症状进行的胸部 CT 检查显示多个肺部结节。然而，在检查结束之前，她就失去了后续行动。除此之外，她的病史并无异常。家族史包括母亲子宫内膜癌。体检显示部分氧饱和度为98%，呼吸频率为每分钟18次，心率为每分钟77次。她的呼吸音和其他全身检查结果正常。肺功能检查结果如下：1秒用力呼气量，预测108%（正常范围80%~120%）；肺总量，预测值的 72%（正常范围，80%–120%）；用力肺活量，预测值的 101%（正常范围，80%–120%）；一氧化碳扩散能力，预测为 69%（正常范围，60%–120%）；和用力呼气中期流量，预测值的 85%（正常范围，40%–160%）。全血细胞计数、红细胞沉降率、C反应蛋白水平、类风湿因子和抗核抗体水平均在正常范围内。使用多排 CT 扫描仪（Ingenuity Core 128；飞利浦医疗系统）对患者进行了胸部体积薄层 CT 评估，以评估肺结节和肺间质。