2016年 · 第50卷第06期

Female, 49 years old. He was admitted to hospital on January 19, 2015 due to repeated cough for 2 years and right chest pain for 2 months. The patient had no expectoration, chills, fever, chest tightness, shortness of breath and discomfort. Physical examination: bilateral neck and superficial lymph nodes of the whole body were unpalpable and enlarged, right chest was slightly tender, and liver and spleen were unpalpable and enlarged. The relevant tumor indexes of laboratory tests were all normal. Thin-slice CT scan showed that there were no abnormal density shadows in both lungs, and multiple nodular soft tissue density masses of different sizes were seen in right oblique fissure, horizontal fissure and subpleura. The density of the masses was uniform, and some nodules fused into lobular masses, the larger one was about 3.2 cm ×1.9 cm, mainly in interlobar pleura (Figure 1，Figure 2，Figure 3）。 CT diagnosis: right interlobar pleural mesothelioma possible. CT-guided percutaneous lung biopsy: HE staining, more histiocytes were seen under the microscope, the cell volume was large, the cells were polygonal and short fusiform, the cytoplasm was rich and light stained, and 1~2 nuclei were seen, and the nucleolus was unclear; There are characteristic phagocytic lymphocytes in the broad cytoplasm, one or more lymphocytes, and interstitial fibrous tissue proliferation (Figure 4）。 Immunohistochemical staining showed that S-100 protein, macrophage antigen (CD68) and leukocyte common antigen (LCA) were positive, and CD1a, cytokeratin (CK) and cell proliferation index (Ki-67) were negative. Right pleural Rosai-Dorfman disease (RDD) was diagnosed by pathology combined with immunohistochemistry.

Male, 43 years old, Korean, was admitted to hospital on May 28, 2015 due to back soreness for 7 d and fever for 2 d. Main clinical manifestations: short course of disease, acute onset, with fever as the main manifestation. Previous history of hyperthyroidism for 7 years. Exposure history: There is a clear history of exposure to patients with middle east respiratory syndrome (MERS), and it is a second generation MERS patient. Physical examination: Body temperature 39.0℃, blood pressure 126/78 mmHg (1 mmHg =0.133 kPa), heart rate 98 beats/min, respiratory rate 21 beats/min, slightly thick breathing sounds in both lungs, no dry and wet rales, uniform heart rhythm, flat and soft abdomen, and normal intestinal sounds. Admission blood routine: white blood cell count 3.22×10⁹/L, neutrophils 2.35×10⁹/L, platelet count 81×10⁹/L, red blood cell count 4.7×10¹²/L. Virus detection: On May 29th, the Chinese Center for Disease Control and Prevention used real-time reverse transcription-polymerase chain reaction (real-time RT-PCR) to detect three nucleic acids of middle east respiratory syndrome coronavirus (MERS-CoV) targets (upE/OPF1b/N2) in three throat swab samples, and the results showed that they were all positive, as well as serum samples, sputum and stool samples.

Male, 50 years old. 10 days ago, I had a cough and pale yellow mucous sputum due to a cold. I went to the local county hospital and performed a chest CT examination to find a mass in my right lung. Usually physically fit. Physical examination: thoracic symmetry without deformity, chest wall without collapse, no tenderness, negative thoracic crush sign, left lung percussion voiceless, right lower lung percussion voiceless, left lung breathing sound normal, right lower lung breathing sound weakened, and both lungs did not hear wet rales.

Regarding the concept of the fifth ventricle, the definition of the fifth ventricle is basically the same in Chinese medical materials that can be found in China, including medical textbooks, books, documents and online texts, that is, the fifth ventricle is also called transparent compartment cavity. Almost all medical workers in China have always believed in this definition. However, in foreign literature reports, the fifth ventricle is usually defined as a cystic cavity located in the conus of the spinal cord and surrounded by ependymal tissue^[1], rather than the transparent compartment cavity, because the tissue structure of the transparent compartment cavity is different from that of the ventricle^[2]。 The author describes the definition, formation mechanism, clinical manifestation and prognosis of the fifth ventricle, and its imaging diagnosis and differential diagnosis, so that domestic readers can re-understand this concept correctly.