Solitary pulmonary nodule. PET-CT בן 45 בריא בדרך כלל עישון - 20 שנות קופסא בצילום חזה לקבלת עבודה חדשה ממצא ריאתי חדש שולל שיעול, קוצר נשימה.

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Presentation transcript:

Solitary pulmonary nodule

PET-CT

בן 45 בריא בדרך כלל עישון - 20 שנות קופסא בצילום חזה לקבלת עבודה חדשה ממצא ריאתי חדש שולל שיעול, קוצר נשימה וגניחת דם

השוואה לצילומים ישנים

Solitary pulmonary nodule Differential Diagnosis Benign –Granuloma infectious (TB, histoplasma, coccidio, echinococcal cyst) non-infectious (Rheumatoid, Wegener, Sarcoid) –Benign Tumor (Hamartoma, Fibroma, Lipoma) –Others (Arteriovenous malformation, Bronchogenic cyst)

Solitary pulmonary nodule Differential Diagnosis Malignant –Lung Cancer. –Bronchial carcinoid –Metastasis (colon, renal, head & neck, breast)

גורמי סיכון לממאירות גיל חשיפה לקרצינוגנים : עישון גודל הקשרית גבולות הקשרית הסתיידויות בקשרית קצב גדילת הקשרית תעסוקתי

מה עושים ?! האפשרויות : – מעקב – בירור באמצעים פולשניים : ברונכוסקופיה, ביופסיית מחט –PET – כריתה כירורגית

Solitary pulmonary nodule (< 3 cm) Observe if Stability documented for > 2 years or Calcifications or Age <35 otherwise Excision

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