每日一题_2024.07.26

A 73-year-old woman had sudden chest pain during pulmonary-function testing. She had a history of breast cancer, for which a double mastectomy with breast reconstruction had been performed 23 years earlier, followed by the insertion of silicone breast implants 12 years later. She also had a history of non–small-cell lung cancer, for which a superior segmentectomy of the right lower lung had been performed by means of open thoracotomy 3 years before presentation. To evaluate the patient’s chest pain, a computed tomographic scan of the chest was performed. What radiographic finding is shown?

一位73岁的女性在进行肺功能测试时突然出现胸痛。她有乳腺癌病史，23年前进行了双侧乳房切除术并重建乳房，随后在12年后植入了硅胶乳房假体。她还有过非小细胞肺癌的病史，3年前通过开胸手术进行了右下肺上叶切除术。为了评估患者的胸痛，进行了胸部的计算机断层扫描。显示的放射学发现是什么？

A. Intrathoracic migration of a breast implant乳房假体胸内迁移

B. Lobar consolidation肺叶实变

C. Loculated pleural effusion局限性胸膜积液

D. Pneumothorax气胸

E. Segmental atelectasis肺段不张

答案解析：

胸部的CT扫描显示右侧乳房假体移位到下胸膜腔内。胸内迁移是乳房植入术极其罕见的并发症。这种情况通常由于肋间肌肉和筋膜的弱点发生，往往与之前的心脏和胸部手术有关。在随后的右侧开胸手术中，乳房假体被取出，胸壁缺陷被重建，她的咳嗽症状后来缓解了。

正确答案：A