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老年淋巴瘤并非少见,但由于病变部位及范围不同,加之老年患者结外病变多见,给临床诊断增加了一定难度,若思路狭窄,很易导致误诊。现将笔者遇及2例报告如下: 例1 女性,68岁。肝脾进行性肿大半年,多次查肝功能异常。因患者原有血吸虫病病史,一直考虑为“血吸虫性肝硬变”。多家医院就诊,给予常规护肝治疗,未奏效。入院时查肝肋下4cm,剑突下6cm,脾肋下5cm,质坚。同时查及颈部肿大的淋巴结,经淋巴结后检确诊为何杰金氏病。采生COPP方案化疗,随访1年仍存活。例2 男性,60岁。左颞部及两下肢皮肤
Elderly lymphoma is not uncommon, but due to the different parts and extent of the lesion, combined with extranodal disease in elderly patients more common, to the clinical diagnosis of a certain degree of difficulty, if the idea is narrow, it is easy to cause misdiagnosis. Now I met two cases reported as follows: Example 1 female, 68 years old. Progressive hepatosplenomegaly six months, many times check liver dysfunction. Because of the patient’s original history of schistosomiasis, has been considered as “schistosomiasis cirrhosis.” Many hospitals for treatment, given conventional liver protection, did not work. Check liver ribs 4cm on admission, xiphoid 6cm, spleen ribs 5cm, quality Kennedy. At the same time check the enlarged neck lymph nodes, diagnosed by Hodgkin’s disease after lymph node examination. Health and COPP regimen chemotherapy, follow-up still alive after 1 year. Example 2 male, 60 years old. Left temporal and two lower extremity skin