患者,男,27岁,20余天来上腹胀满、疼痛,进食后加重,纳差、消瘦,按慢性胃炎治疗效果不佳,于1997年1月21日入院。体查:体温38.2℃,脉搏82次/min,血压16/10 kPa。右颈部触及-3.5cm×3.5 cm大小的包块,质地中等,边界不清,光整,皮肤色泽正常,不活动,无明显压痛。腹软,肝脾未触及,剑突下及左下腹压痛,无反跳痛。实验室检查:血白细胞6.7×10~9/L,淋巴20％,中性80％,红细胞4.6×10~(12)/L,血色素130 g/L,血沉55mm/h尿、粪常规及肝、肾功能检查正常。B超:右颈部探及3.4×2.7 cm实质性团块回声,边界清,内回声欠佳,周边淋巴结多个肿大,回声不匀,肝胆脾胰正常。胃镜检查显示:慢 The patient, male, 27 years old, had more than 20 days of bloating and pain on his upper abdomen, aggravated after eating, anorexia, weight loss, and poor treatment for chronic gastritis. He was admitted to hospital on January 21, 1997. Physical examination: body temperature 38.2°C, pulse 82 beats/min, blood pressure 16/10 kPa. The right neck touched a mass of -3.5cm x 3.5cm, with medium texture, unclear borders, smooth skin, normal skin color, inactivity, and no obvious tenderness. The abdomen was soft, the liver and spleen were not touched, and the xiphoid and lower left abdomen had tenderness and no rebound tenderness. Laboratory examination: white blood cells 6.7×10 9/L, lymph 20%, neutral 80%, red blood cells 4.6×10 12/L, hemoglobin 130 g/L, ESR 55mm/h, feces and liver Kidney function was normal. B-ultrasound: the right neck and 3.4 × 2.7 cm substantial clump echo, border clear, poor internal echo, peripheral lymph nodes swollen, echo uneven, normal liver, gallbladder, spleen and pancreas. Gastroscopy shows: slow