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患儿男,14岁。低热、盗汗、腹痛2月,腹胀、胸闷半月。既往体健,未接种卡介苗。祖父“咳嗽”10余年。体检:消瘦,巩膜无黄染,浅表淋巴结均可触及,黄豆大小。质中、活动,无压痛。锁骨上未触及淋巴结。气管稍向左移位。心与左肺(一);右肺呈实音,呼吸音减低。腹膨,腹围70cm,肝、脾未扪及,左中腹可触及一条状约2×4cm肿块,边界不清,质中,无压痛且不活动。血红蛋白85g/L,白细胞8×10~9/L,中性70％,淋巴细胞26％,嗜酸细胞2％,单核细胞2％,血小板360×10~9/L。二便常规,血钠、钾、氯及肝、肾功能检查皆正常。胸片示右侧胸腔积液。胸腹水均呈淡黄、混浊,李凡他试验(+),WBC分别为54×10~9/L、89×10~9/L,N90～92％,L
Children male, 14 years old. Low fever, night sweats, abdominal pain in February, abdominal distension, chest tightness and a half months. Past physical health, not vaccinated BCG. Grandfather “cough” more than 10 years. Physical examination: weight loss, sclera no yellow dye, superficial lymph nodes can be touched, the size of soybeans. Quality, activity, no tenderness. Clavicle did not touch the lymph nodes. Trachea shifted slightly to the left. Heart and left lung (a); right lung was solid tone, reduced breathing sounds. Abdominal distension, abdominal circumference 70cm, liver, spleen not palpable, the left abdomen can reach a strip of about 2 × 4cm mass, the boundary is unclear, quality, no tenderness and inactivity. 85g / L of hemoglobin, 8 × 10 ~ 9 / L of white blood cells, 70% of neutral, 26% of lymphocytes, 2% of eosinophils, 2% of monocytes and 360 × 10 ~ 9 / L of platelets. Second, routine, serum sodium, potassium, chlorine and liver, renal function tests are normal. Chest radiograph showed right pleural effusion. Pleural and ascites were light yellow, cloudy, Li where he test (+), WBC were 54 × 10 ~ 9 / L, 89 × 10 ~ 9 / L, N90 ~ 92%, L