颈淋巴结肿大、白细胞异常增高、单核细胞“阵雨”现象,并发DIC和糖尿病的慢粒急

• 作 者: 侯天德 吴梦虬 谷锦绵 李志红 谢兴洪
• 机 构: 郑州市第三人民医院,郑州市第三人民医院,郑州市第三人民医院,郑州市第三人民医院,郑州市第三人民医院,
• 出 处: 临床血液学杂志
• 发表日期: 1988年03期
• 关键词: 颈淋巴结肿大 DIC 慢粒 颈部淋巴结肿大 左颈部 肿大淋巴结 鼻咽部 白细胞异常 白细胞数 肋缘

病例介绍:病人男,41岁,干部。左颈部淋巴结肿大两月余,急剧肿大伴白细胞数异常增高20天于1987年12月4日入我院.两月前发现左颈部两个黄豆大小硬结,近20天来左颈部硬结上方出现一包块,疼痛,呈进行性急剧肿大,感低热、乏力。因白细胞38×10~9/L,采用卡那霉素、洁霉素等治疗无效转来院。既往体健.查体:T37.4℃,P92次/分,R22次/分,BP 120/80mmHg.无出血点.左颈部触及6×4×4cm~3一巨大肿块和数个大小不等肿大淋巴结融合,表面光滑,质硬,活动差,无红、热和压痛.扁桃体肿大Ⅱ°,表面苍白,鼻咽部一1×1.5cm~2大小结,表面苍白,触之渗血.胸骨叩压疼。心肺无异常发现,肝肋缘下刚触及,缘锐,无触疼,脾肋

Case description: Patient male, 41 years old, cadre. Left cervical lymph node enlargement more than two months, acute enlargement with an abnormal increase in the number of white blood cells 20 days in December 4, 1987 into our hospital two months ago found the size of the left and neck of two soy bean induration, the past 20 days left neck Appear above the induration of a mass of the package, pain, progressive rapid enlargement, feeling low fever, fatigue. Due to white blood cells 38 × 10 ~ 9 / L, the use of kanamycin, lincomycin treatment ineffective transfer to the hospital. Past physical health. Physical examination: T37.4 ℃, P92 beats / min, R22 beats / min, BP 120 / 80mmHg. No bleeding point. Left neck touched 6 × 4 × 4cm ~ 3 a huge mass and several sizes Such as enlarged lymph nodes fusion, smooth surface, hard, poor activity, no red, heat and tenderness. Tonsil enlargement Ⅱ °, the surface pale, nasopharyngeal 1 × 1.5cm ~ 2 knot, pale surface, Blood. Sternal knock pressure pain. No abnormal heart and lung findings, just under the edge of the liver margin, edge sharp, no touch pain, spleen