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患者男性,35岁。1985年5月出现心慌气短,胸骨疼痛。外院B型超声波和胸透诊断为“心包炎”。用青、链霉素和异烟肼治疗后症状略减轻。同年10月,胸闷气短加重,不能平卧。再次住院治疗同前,并由心包抽液800ml,化验结果不详。1986年10月出现双颈部、腋下淋巴结肿大,一个月后因血象异常,于1986年3月3日收住我院。体检:体温37.1℃,脉搏110次/min,血压130/80mmHg,轻度贫血貌,半卧位,巩膜皮肤无黄染,无皮下瘀斑。两颈部、锁骨上、腋下、滑车上、腹股沟均可触及肿大的淋巴结1.0×1.0至2.0×3.0cm大小,中等硬度,无触痛。胸骨上1/3有压痛。两肺(一)。心界向两侧扩大,心音遥远,心率110次/min,律齐,未听到杂音。腹部平坦,肝大肋下2cm,脾不大,腹水征(一)。实验室检查Hb88g/L,血小板39×10~9/L,WBC14.1×10~9/L,幼稚淋巴细胞95%,血沉55mm/h,BUN
Male patient, 35 years old. May 1985 palpitation shortness of breath, sore chest. Outside the hospital B-mode ultrasound and chest X-ray diagnosis of “pericarditis.” After treatment with cyan, streptomycin and isoniazid slightly reduced symptoms. In October the same year, chest tightness increased shortness of breath, can not lie down. Hospitalized again with the former, and by the pericardial fluid 800ml, the test results unknown. October 1986 double neck, armpit lymph nodes, one month later due to abnormal blood, on March 3, 1986 admitted to our hospital. Physical examination: body temperature 37.1 ℃, pulse 110 beats / min, blood pressure 130 / 80mmHg, mild anemia, semi-recumbent, scleral skin without yellow dye, no subcutaneous ecchymosis. Two neck, supraclavicular, armpit, pulley, groin can reach swollen lymph nodes 1.0 × 1.0 to 2.0 × 3.0cm size, medium hardness, no tenderness. Sternum on the third have tenderness. Two lungs (a). Heart to expand on both sides, distant heart sounds, heart rate 110 times / min, law Qi, did not hear the noise. Abdomen flat, liver ribs 2cm, spleen not, ascites sign (a). Laboratory tests Hb88g / L, platelets 39 × 10 ~ 9 / L, WBC14.1 × 10 ~ 9 / L, immature lymphocytes 95%, erythrocyte sedimentation rate 55mm / h, BUN