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患者男,71岁,因反复咳嗽、咳痰、憋喘18年,加重1周于2001年12月24日入院。给予抗感染、祛痰、平喘等治疗,症状好转,住院期间发现阴囊皮肤改变,在左腹股沟根部见一约2cm×3cm的皮损,呈湿疹样,双侧腹股沟淋巴结未触及肿大,全身体检未见其他皮损,胸片未见异常,阴囊皮损经活检证实为paget’s病(乳房外paget’s病)。于2002年3月18日,在局麻下行阴囊皮肤癌切除术,术后病理示(外阴)原位癌-派杰氏病,黑色素瘤(HMB-45)阴性。该患者18年前曾行左肺叶切除术,术后病理示“腺癌”,15年前行乙状结肠囊腺瘤切除术,12年前行左腮腺区肿物切除术,冰冻结果示“低度恶性腺样囊性癌”,另外,患者还伴有高血压病(30余年),糖尿病、冠心病(10余年)及前列腺肥大、脑梗死等病史。辅助检查:近2年来,多次检测铁蛋白(SF)均>700.0ng/ml(正常为22～322ng/ml),CD_342％、CD_426％、CD_817％、CD_4/CD_81.52,NK细胞11％;肝功能、生化、
Male patient, aged 71, was admitted to hospital on December 24, 2001 due to repeated cough, sputum, and wheezing for 18 years. Given anti-infective, expectorant, asthma and other treatment, the symptoms improved, scrotal skin was found during hospitalization in the left groin root see a 2cm × 3cm of the lesion was eczema-like, bilateral inguinal lymph nodes did not touch the enlargement, body No other skin lesions on examination, chest X-ray showed no abnormalities, scrotal skin lesions biopsy confirmed paget’s disease (breast outside paget’s disease). On March 18, 2002, scrotal skin cancer resection was performed under local anesthesia. Postoperative pathology (vulva) carcinoma in situ - Papay’s disease and melanoma (HMB-45) were negative. The patient had a left lobectomy 18 years ago, postoperative pathology showed “adenocarcinoma”, 15 years ago sigmoid cystadenoma resection, left parotid gland tumor resection 12 years ago, frozen results show “low Malignant adenoid cystic carcinoma, ”In addition, patients with hypertension (more than 30 years), diabetes, coronary heart disease (more than 10 years) and benign prostatic hyperplasia, cerebral infarction and other medical history. Auxiliary examination: In the recent two years, the detection of ferritin (SF) was> 700.0ng / ml (normally 22 to 322ng / ml), CD342%, CD426%, CD817%, CD4 / CD81.52, and 11% ; Liver function, biochemistry,