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        鼻咽癌病例
         

        鼻咽癌病例

        患者叶某?#24120;?#30007;性33岁广东东莞人患者自2013年6月初因涕血2周发现鼻咽肿物2日到365bet官网,365bet体育在线就诊患者无明显诱因出现回吸血涕无面麻耳鸣鼻塞头痛听力下降复视耳痛等未予处理涕血较前增多于2013-6-4在365bet官网,365bet体育在线行鼻咽?#23548;?#26597;考虑鼻咽增厚2013-06-04鼻咽MRI示1鼻咽顶后壁粘膜结节状增厚隆起伴右侧?#23460;?#31389;变浅2双侧颈深间隙双颈II区及右侧III区咽后间隙散在多发淋巴结小部分颈深部淋巴结增大EB病毒核酸定量检测<5.0E+03基因拷贝/ml鼻咽活检病理示免疫组化P63CKCK5/6P53EGFR均+Ki6760%+LCA-原位杂交EBER+结合免疫组化结果诊断鼻咽未分化?#22836;?#35282;化性癌心电图胸片腹部B超及全身骨ECT均未见异常疾病分期为T1N1M0期给予同期顺铂增敏化疗调强放疗放疗计划6MV-X线IMRT各靶区照射剂量PGTVnx68.2Gy/2.2Gy/31fPGTVnd66Gy/2.15Gy/31fPCTV162.0Gy/2.0Gy/31fPCTV255.8Gy/1.8Gy/31fPCTVnd55.8Gy/1.8Gy/31f2013-06-242014-08-05予调强放疗2013-06-2407-0107-0807-1507-2207-29同期顺铂增敏化疗治疗过程顺利放疗结束?#22791;?#26597;MRI示1原鼻咽顶后壁粘膜肿瘤基本消失2原Ia双侧咽后IbIIaIIbIII区和右侧V区多发淋巴结较前缩小双侧咽后间隙及II区淋巴结较前明显缩小患者放疗结束后1个月3个月半年9个月及1年按时返院复查复查颈+鼻咽MRI胸片腹部彩超等检查提示未见肿瘤复发转移放疗后1年复查PET/CT均未见明显肿瘤未控转移?#26696;?#21457;征像

          备注放疗前MR图像         备注放疗结束MR图像        备注放疗后一年复查
               



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