Famous Among Top Surgeons in the 90s-Chapter 1879: The Cowardly and Aggressive Disease
The current X-ray of the patient shows that the condition of the lungs is generally normal, except for some lung fibrosis. The county hospital’s suspicion that pneumonia is unresolved has some basis but requires more careful discernment. Without a CT scanner, this is as far as the judgment can go. Currently, with available conditions, clinical doctors can combine CT scans for further judgment. The lung tissue textures are coarse and blurred, the bronchial walls are thickened, and fibrosis is partially evident. Bronchial inflammation is present, consistent with Chang Jiawei’s previous assessment.
Seeing this, Xie Wanying couldn’t help but admire Teacher Chang for being very accurate despite not being a cardiopulmonary specialist.
Beside her, only Student Geng was heard asking the class leader: why someone suspects his brother has tuberculosis.
For now, there are no characteristics of tuberculosis on the current lung X-ray.
Before Fu Xinheng and Chang Jiawei arrived, the suspicion that the patient had tuberculosis could only have been from Teacher Ren or Doctor Guo. Specifically, Teacher Ren, not being a clinical doctor, would not express opinions but rather come to understand the situation. It could only be Doctor Guo who had suspicions.
Hearing the students’ discussion, Fu Xinheng, who had just arrived and hadn’t had time to understand the full picture of the patient’s condition, asked Doctor Guo: "Why do you suspect he has tuberculosis in the lungs, and what’s your reason?"
After all, as a cardiothoracic surgeon, he is willing to bet that these X-rays cannot diagnose the patient with pulmonary tuberculosis at all.
Doctor Guo, carefully wiping his palms in the face of the superior teacher’s questioning, answered about his medical reasoning path: "The X-rays currently do not show anything. But previously, the patient’s medical history was understood. It is said that there is an old grandparent at the patient’s home who has been smoking for years and often coughs; it cannot be ruled out that this old man has a history of tuberculosis. Pulmonary tuberculosis is just one form of tuberculosis, Teacher Fu."
Most tuberculosis bacteria invade the lungs, therefore it is commonly referred to as pulmonary tuberculosis. Most people habitually equate tuberculosis with pulmonary tuberculosis, which is wrong. Tuberculosis refers to the infection of the body by the tuberculosis bacillus, and depending on the location of the infection, it can be classified into pulmonary tuberculosis, gastrointestinal tuberculosis, lymph node tuberculosis, etc. However, these are rarely seen clinically and are considered rare cases, as with spinal tuberculosis.
Spinal tuberculosis is different in that most spinal tuberculosis seems to be secondary tuberculosis rather than primary disease. The so-called secondary, like tumor metastasis, means the tuberculosis bacillus did not directly invade the spine but reached the spine through blood circulation from other primary sites like pulmonary or gastrointestinal tuberculosis.
Doctor Guo’s suspicion of tuberculosis is definitely not based on the featureless lung X-ray but originates from the spine X-ray.
The spine X-ray includes both anteroposterior and lateral views. The anteroposterior view shows the lesion area between several vertebrae, seemingly showing invaded soft tissue and signs of bone destruction. Clinically, a significant difference between spinal tuberculosis and spinal tumors may lie in this aspect.
Unlike tumors, tuberculosis bacillus is humorously referred to by top medical experts as a "coward" that bullies the weak, first attacking the body’s soft tissues, equating to bullying the weak. Tumors are entirely the opposite, preferring to confront and destroy the body’s bone tissue, considering soft tissue almost disdainfully or in passing. This typical difference leads most doctors, when seeing signs of soft tissue destruction on X-rays, to first question if it’s tuberculosis. 𝗳𝗿𝐞𝕖𝘄𝗲𝕓𝗻𝚘𝚟𝕖𝐥.𝚌𝕠𝕞
Of course, every patient has individual differences. Some patients have special bodies and may show reversed symptoms, which are all factors doctors must consider.
