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5岁男孩,以发热四月,两下肢疼痛伴行走困难二月为主诉入院,近一月腹部胀痛。查体:T39℃,左右腹股沟处可扪及花生大小淋巴结数个,质软,肝右肋下4.5cm,质中等,压痛,移动性浊音(+),脊柱腰段后凸,右侧较饱满,两下肢屈曲少动,右髂窝深压痛、A 超示肝增大并少量腹水。B 超发现右腹膜后有一直径10cm 以上、被膜光滑的异常不均质回声增强区,与右肾上腺上极紧贴,下腔静脉旁淋巴结肿大,意见为右肾上腺神经母细胞瘤伴腹膜后淋巴结转移,尿VMA23.64mg/24小时尿,IVP 符合神经母细胞瘤改变,骨髓检查找到神经母细胞瘤细
5-year-old boy with fever in April, two lower extremity pain accompanied by walking in February, the main complaint was admitted to the hospital, nearly a month of abdominal pain. Physical examination: T39 ℃, around the inguinal palpable peanut-sized lymph nodes, soft, right rib 4.5cm, moderate quality, tenderness, mobility dullness (+), lumbar lumbar kyphosis, the more full on the right , Lower extremities less flexion, deep right iliac fossa, A super showed liver enlargement and a small amount of ascites. B-found after the right retroperitoneal diameter of 10cm or more, the smooth coating of the abnormal heterogeneous echo enhancement zone, and the right adrenal very close, next to the inferior vena cava lymph nodes, the views of the right adrenal neuroblastoma with retroperitoneal lymph node Metastasis, urine VMA 23.64mg / 24 hours urine, IVP in line with neuroblastoma change, bone marrow examination to find neuroblastoma fine