患者女,38岁,1979年12月发现右小腿有一黑豆大黑斑,至1983年11月黑斑有所增大,且胸背部出现散在性针尖大褐色丘诊,同时伴胸痛、气短,消瘦而就诊、经胸片诊为“粟粒型肺结核”转我院。体检T37.2℃,消瘦,右小腿屈侧偏下皮肤有0.5cm~2呈桔皮性圆形黑斑,前胸及后背皮肤有散在性多数小米粒大黑色丘疹样结节,颈部右侧有黄豆大较硬淋巴结。胸部左侧腋中线第7肋下叩浊,语颤及呼吸音减弱,心脏听诊(-),肝肋下1cm。左胸腔抽出草黄色胸液460ml。化验黑色素尿试验(+),胸水:细胞数200个/dl,L70％,N30％,Rivalta反应弱阳性, The female patient, 38 years old, had a black spot on her right calf in December 1979 and had dark spots on November 1983. She had a large, brown needle on the chest and back, with chest pain, shortness of breath, and wasting. The treatment and transthoracic diagnosis of “miliary tuberculosis” were transferred to our hospital. Physical examination T37.2 °C, weight loss, 0.5cm~2 orange peel round dark spots on the skin of the right calf flexor, and large black pimples-like nodules on the skin of the chest and back. On the right side, there are large, harder lymph nodes. On the left side of the thorax, the thorax was turbid under the seventh rib, speech and tremor and breath sounds were weakened, the heart was auscultated (-), and the liver was 1 cm below the ribs. Left chest out of grass yellow broth 460ml. Test melanin urine test (+), pleural effusion: 200 cells/dl, L70%, N30%, weak Rivalta reaction,