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患者男性,35岁,因左小腿肿痛,全身畏寒发热50天,1984年12月4日入院。曾于1980年10月在上海某医院诊断为慢性粒细胞白血病。检查:消耗病容,颈部正常,心肺正常,腹软,肝肋下1指,剑突下4指,质硬。脾脏肋下5指,平脐,质硬,无触痛。腹水征(一)。左腹股沟可扪及3枚如鸽蛋大小之淋巴结,右侧有2枚如蚕豆大小,压痛不明显。左小腿中段前侧有5×6cm~2肿块,皮肤不红,肿块质硬,不活动,试穿无脓液,左膝关节活动正常。化验检查:血常规:RBC:0.36×10~(12)/L.Hb:100g/L.WBC:30.9×10~6/L,N:0.78L:0.22,分类中发现幼稚细胞,血沉30mm,AKP<10~(?)(金氏),血钙4.5mEq/L,肝功能正常,AFP(一),x 线左小腿正侧位片示:左胫骨中段呈虫蚀样改变,密度不均匀,无活动性病灶。A 超提示肝脏剑下7cm、肋下1cm 上界第6肋间,前后径8.5cm,有较
Male patient, 35 years old, because of left leg swelling and pain, general chills and fever 50 days, December 4, 1984 admission. Had in October 1980 in Shanghai, a hospital diagnosis of chronic myeloid leukemia. Check: consumption of disease, normal neck, normal heart and lung, abdominal soft, liver ribs under 1 refers to the xiphoid 4 fingers, hard. Spleen ribs 5 means, flat navel, hard, no tenderness. Ascites sign (a). Left groin palpable three such as pigeon egg size of the lymph nodes on the right there are two such as the size of beans, tenderness is not obvious. Left front of the middle of the left leg with 5 × 6cm ~ 2 mass, the skin is not red, mass hard, inactive, try on no pus, left knee joint activity is normal. Laboratory tests: blood: RBC: 0.36 × 10 ~ (12) /L.Hb:100g/L.WBC:30.9 × 10 ~ 6 / L, N: 0.78L: 0.22, found in the classification of naive cells, ESR 30mm, AKP <10 ~ (?) (Kim), serum calcium 4.5mEq / L, normal liver function, AFP (a), x-ray is shown on the left leg is a lateral shift: , No active lesions. A super tips under the sword of the liver 7cm, rib 1cm upper bound 6th intercostal anteroposterior diameter 8.5cm, more