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患者,男,54岁,消瘦乏力,食欲差,干咳,夜间有时出汗月余,于1995年4月24日就诊.体检:体温37℃,心肺(一),浅表淋巴结肿大.X线检查:摄胸片见右上纵隔向右凸出之弧形块状影,边缘光滑,侧位片见肺门上方处示团块状致密影,大小约6×4cm.边界不清,肺门影增浓,增宽.实验室检查:白细胞10.0×10~9/L,血沉120mm/小时,痰结核菌检查3次均阴性,痰细胞学检查3次均阴性.初步印象:纵隔淋巴瘤?肺癌?结节病?患者转院会诊,认为纵隔淋巴系肿瘤可能性大,肺结核不除外,建议抗结核治疗2个月后复查.采用异烟肼0.4g/日,利福平0.6g/日顿服,链霉素O.75g/日1次肌注,2个月后摄片复查,见此肿块明显缩小,继续用药治疗1个月,摄片复查,见肿块已
Patient, male, 54 years old, with weakness, poor appetite, dry cough and sometimes sweating at night, visited on April 24, 1995. Physical examination: body temperature 37 ℃, cardiopulmonary (A), superficial lymph nodes. Check: see the right chest X-ray film to the right of the mediastinum protruding to the right of the arc-shaped massive shadow, the edge of a smooth, lateral view of the top of the hilum showed massive clumps, the size of about 6 × 4cm. The border is unclear, hilar Thickening, widening Laboratory tests: white blood cells 10.0 × 10 ~ 9 / L, erythrocyte sedimentation rate 120mm / hour, sputum TB test were negative for 3 times, sputum cytology 3 times were negative.Preliminary impression: mediastinal lymphoma? Lung cancer Sarcoidosis patients referral consultation, that the possibility of mediastinal lymphatic system is large, except for tuberculosis, anti-tuberculosis treatment recommended 2 months after the review with isoniazid 0.4g / day, rifampin 0.6g / Dayton clothing , Streptomycin O.75g / day 1 intramuscular injection, 2 months after the film review, see this mass was significantly reduced, continue treatment for 1 month, radiography review, see the mass has