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患女,37岁。因上腹部痛,有包块,进行性消瘦半年入院。患者半年前自觉腹痛呈间歇性发作,不向别处放射,与进餐无关,伴午后低热、盗汗,自己扪及中上腹包块,初如鸡蛋大小,渐增大如拳头,胃纳差,进行性消瘦,二便如常。平素体健。查体:T37℃,神清、消瘦、贫血貌,全身浅表淋巴结不肿大。巩膜无黄染。心肺未见异常。中上腹局限性隆起,扪及12cm×9cm×7cm肿块,质硬边界欠清,表面结节状、不活动。肝脾未及,腹水征阳性。Hb 80g/L,WBC 6.2×10~0/L,N0.70、L0.30,ESR 115mm/h。粪尿常规正常,隐血试验阴性。肝肾功能正常。胸片未见结核病灶。纤维胃镜检查报告为浅表性胃炎。B超检查见胰头与胰体多个不等结节状中低回声,
Female, 37 years old. Due to upper abdominal pain, a mass, progressive weight loss six months admitted. Patients with abdominal pain half a year ago was intermittent seizures, not to other parts of the radiation, has nothing to do with the meal, with afternoon fever, night sweats, palpable in the belly mass, the beginning such as egg size, increasing fist, poor appetite, Sexual weight loss, two will be normal. Usually physical health. Examination: T37 ℃, Shen Qing, weight loss, anemia appearance, systemic superficial lymph nodes is not enlarged. Sclera without yellow dye. Heart and lung no abnormalities. In the upper limit of the uplift, palpable mass 12cm × 9cm × 7cm, the lack of hard boundaries, surface nodular, inactive. Lack of liver and spleen, ascites sign positive. Hb 80 g / L, WBC 6.2 × 10 ~ 0 / L, N0.70, L0.30, ESR 115 mm / h. Urine routine normal occult blood test negative. Liver and kidney function is normal. No chest X-ray findings. Fiber gastroscopy reported as superficial gastritis. B ultrasound examination of the pancreatic head and pancreas see multiple nodules in the hypoechoic,