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病历摘要吴××,男性,35岁;农村教师。右颈包块10个月。患者于1957年2月份起发现右颈根蚕豆大包块,因无不适,未引起注意。5月份起有低热,当地就诊作“淋巴结炎”治疗无效。9月份察觉包块有核桃大,而至某医院检查,仍未能明确诊断。10月份在某医院经局部穿刺找到“腺癌细胞”,但未发现原发灶,随即使用抗癌药物(5氟脲嘧啶,环磷酰胺)治疗,包块未见缩小。11月份起包块明显增大,出现右上肢麻痛。12月初出现声嘶,右侧面部及右上肢不出汗。12月19日来我所门诊检查:右颈中下巨大包块7×7×8立方厘米,坚实固定,颈略粗,右前上胸壁可见静脉怒张,右侧睑裂小,右眼球凹陷,右侧瞳孔明显小于左侧,
Medical records summary Wu X, male, 35 years old; rural teachers. Right neck mass 10 months. In February 1957, the patient discovered a large mass of right-rooted faba bean, which caused no discomfort and did not attract attention. Since May, there has been fever and local treatment for “lymocyanitis” has failed. In September, he noticed that there were large walnuts in the mass, but he was still unable to confirm the diagnosis. In October, a local puncture was performed in a hospital to find “adenocarcinoma cells,” but no primary lesions were found. Immediately after treatment with anticancer drugs (5-fluorouracil, cyclophosphamide), no reduction in mass was seen. From November onwards, the mass was significantly increased and there was an numbness in the right upper extremity. There was a hoarseness in early December and the right side and upper right limbs did not sweat. On December 19th, we came to our clinic for examination: a large mass of 7 x 7 x 8 cm3 in the middle and lower right middle of the neck was solidly fixed with a slightly thicker neck. There was a visible venous engorgement on the right anterior chest wall, a small right palpebral fissure and a depression of the right eye. The right pupil is significantly smaller than the left,