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1 病例介绍患者,女,28岁.因发热,乏力半月于1993年11月25日入院.体检:T39℃,P85次/min,BP13/gkPa,轻度贫血貌,皮肤、粘膜无黄染,无出血点,浅表淋巴结无肿大,心、肺正常,肝无肿大.脾肋下1.5cm,其余均无异常.既往史、家族史均无待殊.实验室检查;Hb80g/L,WBC2.8X10~9/L.分类:N0.46,L0.47,M0.06,异常组织细胞0.01,BPC60 X 10~9/L,尿、大便常规均(-),肝、肾功能、ANA、红斑狼疮细胞、胸片检查均(-)B超示脾肿大.骨髓有核细胞增生活跃,异常组织细胞0.57,胞体明显大小不均,形态呈多形性畸形,核形多不规则,染色质呈细网状,核仁1～6个,且大而清楚,胞浆着灰蓝色,部分细胞浆内含有空泡;粒系;中幼粒0.02,晚幼粒0.05.杆状核0.07,分叶核0.05;红系;早幼红0.01,中幼红0.08,晚幼红0.03,形态均无异常;全片见巨核细胞4个,血小板少见,诊断恶性组织细胞病.给予去甲氧柔红霉5mg/d,第1～3天静注;阿糖胞昔100mg/d,第1～7天静滴.化疗后8天,Hb46g/L,WBC0.6×10~9/L,N0.17,L0.73,M0.10,BPC30×10~9/
1 Case Introduction Patients, female, 28 years old. Fever and fatigue for half months admitted to hospital on November 25, 1993. Physical examination: T39°C, P85 beats/min, BP13/gkPa, mild anemia appearance, no yellow staining of skin and mucous membranes, No bleeding, superficial lymph nodes without enlargement, normal heart and lungs, no enlargement of the liver. Spleen and ribs were 1.5cm, the rest had no abnormalities. Previous history and family history were not required. Laboratory tests; Hb80g/L, WBC2.8X10~9/L. Classification: N0.46, L0.47, M0.06, abnormal tissue cells 0.01, BPC60 X 10~9/L, urine, stool routine (-), liver, kidney function, ANA , Lupus erythematosus cells, chest X-ray examination are (-) B ultrasound showed splenomegaly. Bone marrow nucleated cell hyperplasia, abnormal tissue cells 0.57, cell body size is not uniform, the shape showed polymorphous malformations, irregular nuclear shape, Chromatin was finely meshed, with 1 to 6 nucleoli, large and clear, cytoplasm with grayish blue, and part of the cytoplasm contained vacuoles; granules; middle and young granules 0.02, late granules 0.05. rod-shaped nucleus 0.07, lobar nucleus 0.05; erythroid; premature young red 0.01, young red 0.08, late young red 0.03, no abnormalities in morphology; 4 megakaryocytes seen in the whole slice, rare platelets, diagnosis of malignant histiocytosis. O. rufiposide 5 mg/d, intravenous injection on days 1 to 3; arabinose 100 mg/d, number 1 to 7 Tian Jing Di. 8 days after chemotherapy, Hb 46g/L, WBC 0.6×10~9/L, N0.17, L0.73, M0.10, BPC30×10~9/