Chen Xia was a little confused when he received this call for help:
"Hey, Director Luo, you senior directors are reading the X-rays, but you still want a junior doctor like me to come over and take a look?"
Luo Wei felt very embarrassed. She was a business backbone in her 40s, but she had to seek advice from a "barefoot doctor" who had only a secondary technical school degree. But now there was no other way.
"Chief Chen, don't be so modest. It was you who suggested buying the CT scan. I don't believe you can't read the film. Come over here quickly. Director Feng is waiting."
"Okay, then I'll come and take a look. You have to give me a share of the subsidy when it's distributed."
"Get out, hurry up."
When Chen Xia appeared in the CT room, a group of people had already gathered inside. A CT film was placed on the film reader. Everyone was crowded together, head to head, listening to Luo Wei and Shi Zhixian's respective reasons.
Seeing that no one paid attention to him, Chen Xia squeezed through a few young doctors and went in. As soon as he saw the film, he blurted out:
"Oh, this person is so unlucky, it's peripheral lung cancer."
Shi Zhixian was unhappy when he heard this and said without turning his head:
"How could this be lung cancer? Inflammatory pseudotumors also have burrs. We can't just say it's lung cancer because of the burrs. Look, the edges here are quite smooth."
When everyone saw Chen Xia coming, they immediately dispersed. They were almost suffocating from being crowded together.
Chen Xia patted the middle-aged doctor on the shoulder.
"Even when looking at spicules, you have to distinguish between long and short spicules. Inflammatory pseudotumors are indeed dominated by long spicules. Lung cancer spicules vary in length, and the short spicules are very diagnostically significant."
He then pointed at the burrs on one side of the film and said, "Look, this is a typical short burr. If it were a long burr, it would usually be this long."
Oh~~~
Everyone agreed with what he said, but it was obvious that this statement did not convince anyone.
Bai Yunjun took the opportunity to say, "Mr. Chen, can you tell us why you insisted on confirming lung cancer on this CT scan?"
Everyone nodded in agreement, even Luo Wei and Shi Zhixian pricked up their ears. Who was right and who was wrong in this first difficult case would directly affect the big question of who would be the authority in the CT room in the future.
Not everyone who comes out of the hospital is as brainless as Gu Lin and Chen Xia. They all have high IQ and EQ, and most of them are very calculative and care about a lot of things.
Chen Xia pointed at the nodule and said, "Look, doesn't this nodule look like a circle? Instead, it looks a bit like three leaves."
Everyone looked carefully, and even Feng Runguang pushed his glasses up.
"From an imaging perspective, this is called the lobulation sign, which is the most common sign of small peripheral lung cancer. Everyone knows that malignant lung nodules are composed of many cancer cells, which absorb nutrients from the human body and continue to multiply and grow.
However, the proliferation rates of many cancer cells are inconsistent, with some reproducing faster and others slower. The faster-growing cancer cells will protrude faster, or be blocked by the surrounding connective tissue, resulting in multiple protrusions on the tumor surface, which looks like a leaf when viewed from a CT scan.
Feng Runguang and Luo Wei were experienced doctors after all. They understood the logic as soon as they heard it and nodded repeatedly.
Even Shi Zhixian felt a little dejected after hearing this. It seemed that he would have to be second in command for the rest of the year.
At this time, another young doctor asked, "Mr. Chen, you said that lobulation is a manifestation of lung cancer. Are there any other typical signs of lung cancer?"
"Yes, for example, the burr sign we saw earlier is called a burr sign on the film. This is because there are multiple small burrs extending around the tumor, and the malignancy is usually higher than that of a nodule with smooth edges.
What are spicules? They are caused by tumor cells blocking pulmonary blood vessels or lymphatic vessels, leading to thickening of the pulmonary interlobular septa and localized fibrosis, or the collapse of a small number of adjacent alveoli, resulting in atelectasis. Where spicules are seen, 90% of cases are malignant tumors.
Oh~~~~
Several young doctors were already taking notes with their heads down.
"There is also a type called spinous process sign, which is caused by the fact that in some lung cancers, by chance, a group of special forces with strong combat capabilities will appear. They reproduce rapidly and can penetrate the surrounding lung tissue like sharp spikes.
This form of cancer cells is more aggressive and grows faster. Most patients only have a few months to live, and current treatments are completely ineffective."
Chen Xia was afraid that everyone didn't understand, so he drew it on paper. After all, no matter how good the description was, it was easier to remember than seeing it with the eyes.
When everyone saw the protruding corner of the nodule on the white paper, they all felt a chill in their spines, hoping that they would not get this unfortunate disease in the future.
Then Chen Xia drew another sign of lung cancer.
"Look again, the bronchus is a hollow tube that goes deep into the lungs on both sides like branches and becomes thinner and thinner until it finally reaches the alveolar cavity. It is the tube for air to enter and exit the alveolar cavity.
At this time, cancer cells arising in the bronchial mucosa will gradually swell and grow, blocking the bronchi. Parabronchial malignancies can also invade the tracheal wall and grow into the lumen, causing bronchial truncation. This bronchus loses its ability to ventilate the lungs, a condition called bronchial truncation.
After such explanation and summary, everyone immediately understood the four special signs, especially the young doctors, who were so excited and admiring that they wanted to bow down in worship.
Chen Xia was still a little proud in his heart and continued teaching:
"Single malignant nodules, especially peripheral lung cancer, have many typical features on CT scans. Once you are familiar with these features, you can see through the disguise of malignant lung nodules. Today, I will share with you four common malignant features. They are very simple and I guarantee that you will learn them after reading them once."
After saying this, he wiped his hair with one hand and said, "Don't envy me, I'm just a legend."
Feng Runguang angrily scolded, "You little bastard, I don't know where you learned all this CT knowledge from. You only know the basics. What a boast!"
Luo Wei studied for half a year and was actually quite impressed by Chen Xia's knowledge that came out of his mouth:
"No, this isn't superficial knowledge. It's based on solid theoretical and practical knowledge. Chen Xia, where did you learn all this? The doctors at the Provincial First Hospital have never mentioned it."
"Haha, well, well, I'm quite open-minded and eager to learn. This time when we went to Hong Kong, the leaders went to buy a CT scan, and with my grandfather's help, I spent several days learning about film reading from the doctors there."
Oh,~~~~~
It makes sense. He has a good grandfather in Hong Kong, and the doctor gives him special treatment. I guess he can learn a lot.
But no one would have imagined that during his time in Hong Kong, Chen Xia was busy doing middleman work all day and had no time to learn CT.
"Ahem, but you're on the wrong track. Clinical diagnosis places too much emphasis on CT."
"Oh, what do you mean?"
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