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1 病例报告例1 男,39岁。1996-05自觉左股中部外侧不适,可触及约2cm×3cm硬结,按皮肌炎治疗无效。4mo后感右上腹不适,超声及CT发现肝脏弥漫性占位性病变。查体:巩膜无黄染,浅表淋巴结未触及。心肺未见异常,肝脾不大,腹水征阴性。左股中部外侧可触及约6cm×3cm硬结,无疼痛,边界不清。HBV三对正常,抗HCV(-),ALT正常.左股硬结活检及肝超声引导下活检,病理报告肝细胞癌。例2 男,28岁。因咳嗽、胸闷3~+mo,面部水肿、双上肢肿胀10d入院。伴发热、胸部堵塞感,不能平卧,咽下困难,无咯血、尿少、双下肢水肿。当地拍胸片及肺CT提示右上纵隔占位病变,怀疑淋巴瘤。查体:神清,巩膜无黄染,浅表淋巴结不大。
1 Case report 1 Male, 39 years old. 1996-05 Self-conscious left and right lateral femoral discomfort, palpable about 2cm × 3cm induration, treatment of dermatomyositis was ineffective. After 4 months, the right upper quadrant discomfort was felt. Ultrasound and CT revealed diffuse lesions in the liver. Physical examination: The sclera did not stain yellow and superficial lymph nodes were not touched. Cardiopulmonary no abnormalities, liver and spleen is not large, negative ascites. About 6cm × 3cm induration can be touched on the medial side of the left thigh, no pain, and the border is unclear. HBV three pairs of normal, anti-HCV (-), ALT normal left iliac induration biopsy and liver ultrasound-guided biopsy, pathology reported hepatocellular carcinoma. Example 2 Male, 28 years old. Because of cough, chest tightness 3 ~ + mo, facial edema, double upper limb swelling 10d hospitalized. With fever, chest congestion, can not lie, swallowing difficulties, no hemoptysis, oliguria, edema of both lower extremities. Local chest radiographs and CT scans of the lungs suggest lesions in the upper right mediastinum and suspected lymphomas. Physical examination: Shen Qing, the sclera is not yellow stained, superficial lymph nodes are not large.