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本文报道1例以糖尿病酮症酸中毒为衰现的恶性生长抑素瘤病例在临床、生化和形态学方面的特点,并讨论了肿瘤分泌的生长抑素的异质性。病例为74岁男性退休木工,有排恶臭脂质便、饱胀、体重明显下降和中度贫血等症状。X 光和 CT 检查发现左肺尖有一肿物,肝有多个肿块,胰腺正常。血癌胚抗原(CEA)增高,甲胎蛋白(AFP)正常,肝活检诊为低分化腺癌。在接受5-氟尿嘧啶(5-FU)、长春新碱(VCR)和丝裂霉素 C 治疗后第8天,病人出现糖尿病酮症酸中毒,表现为多尿、多食、嗜睡、库氏
This article reports a case of malignant somatostatin nephropathy with diabetic ketoacidosis in clinical, biochemical and morphological characteristics, and discuss the tumor secreted somatostatin heterogeneity. The case was a 74-year-old man who retired from carpentry, had stools with fat, fullness, weight loss and moderate anemia. X-ray and CT examination found a left lung tip tumor, multiple lumps, normal pancreas. Blood carcinoembryonic antigen (CEA) increased, alpha-fetoprotein (AFP) normal, liver biopsy diagnosed as poorly differentiated adenocarcinoma. On the 8th day after treatment with 5-fluorouracil (5-FU), vincristine (VCR) and mitomycin C, patients developed diabetic ketoacidosis manifested as polyuria, polyphagia, lethargy,