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急性白血病的诊断一般并不困难,但是,有些病例临床表现不典型或有某些特殊的临床表现,则诊断往往比较困难,易致误诊。为了从误诊中吸取经验教训,提高对本病的早期诊断水平,现将误诊原因举例分析探讨如下。病案举例一、因以胸腔积液为主要表现而误诊为结核性胸膜炎。【例1】王某,男,22岁,农民。因发热、轻咳、盗汗2个月,伴胸闷、气促十多天于1974年6月4日入院。体检:体温39.5℃,皮肤粘膜无出血,浅表淋巴结无肿大,有左胸积液征,腹软,肝脾未触及。化验:血红蛋白6.2克%,血小板11.8万/立方毫米,白细胞3,300个/立方毫米,中性带状核21%,中性分叶核45%,淋巴细胞29%,单核细胞1%,可疑幼稚细胞4%,经复查白细胞10,600个/立方毫米,中性带状核2%,中性分叶核70%,淋巴细胞27%,嗜酸粒
Diagnosis of acute leukemia is generally not difficult, but some cases of atypical clinical manifestations or have some special clinical manifestations, the diagnosis is often more difficult to easily lead to misdiagnosis. In order to learn from the misdiagnosis of lessons learned and improve the early diagnosis of the disease level, the reasons for misdiagnosis will now be analyzed as follows. Case 1, due to pleural effusion as the main performance misdiagnosed as tuberculous pleurisy. [Example 1] Wang, male, 22 years old, farmer. Due to fever, light cough, night sweats 2 months, with chest tightness, shortness of breath more than 10 days in June 4, 1974 admission. Physical examination: body temperature 39.5 ℃, skin and mucous membrane without bleeding, superficial lymph nodes without swelling, left chest fluid sign, abdominal soft, liver and spleen not touched. Assay: 6.2 g% hemoglobin, 118,000 platelets per cubic millimeter, 3,300 leukocytes per cubic millimeter, 21% neutral nucleus, 45% neutral lobes, 29% lymphocytes, 1% monocytes, suspicious naive Cells 4%, after review of white blood cells 10,600 / mm3, 2% of the neutral nucleus, neutral lobular 70%, lymphocytes 27%, eosinophils