A Left Lower Lung Mass in a Hodgkin's Disease Patient

放射治療在何杰金氏症的治療上具有傳統的角色。本文報告一位第二期何杰金氏症接受放射治療後兩個月，左下肺出現腫塊病變，該腫塊位於心臟左外側下緣，並且造成橫隔膜側影的模糊。因為該腫塊的病變位置與一般所認知的因“斗蓬照射”後引起從隔腔旁的放射線肺炎並不吻合，以致於該腫塊一度被判讀為腫瘤或肺結核腫塊。但是經過我們比對橫隔膜下照野後發現，其位置與該照射位置吻合，應是脾臟照射後引起的放射線肺炎。經過檢查及僅症狀上的治療後，該腫塊在三個月後自行消失。這個少見的案例顯示，了解放射線照野的安排，對於正确地判讀何杰金氏症病人治療後的胸部X光片的重要性。

關鍵字

放射線肺炎；何杰金氏症；脾臓

並列摘要

Radiation therapy played a classic role in the radical treatment of localized Hodgkin's disease. We described a Hodgkin's disease patient, stage ⅡA, who was found a left lung mass on a chest film 2 months after irradiation. The mass was near the left lower heart border and obliterated the left diaphragm silhouette. Because the location was quite different from the commonly recognized paramediastinal radiation pneumonitis following mantle-field irradiation, the lesion has been mistakenly interpreted as a recurrent tumor or tuberculoma. After reviewing and comparing the chest radiograph with the subdiaphragmatic port-film, a diagnosis of radiation pneumonitis due to spleen irradiation was suspected. Given only symptomatic treatment, the mass spontaneously resolved 3 months later. The unusual case highlighted the importance of knowledge of the radiationport arrangement on the correct interpretation of a follow-up chest radiograph in Hodgkin's disease patients receiving radiotherapy.

並列關鍵字

Radiation pneumonitis ； Hodgkin's disease ； Spleen

國際替代計量

A Left Lower Lung Mass in a Hodgkin's Disease Patient

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