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患者,男性,53岁．因腹胀,纳差一年加重一周于1987年6月来我院门诊。查体:一般情况欠佳,贫血貌,左侧颈部,左右侧锁骨上、腹股沟均可触及肿大的淋巴结数枚,直径2~8厘米,质中,心肺正常,腹部膨隆,肝肋下5~6厘米,剑突下lOcm,脾肋下4厘米。胸部X线检查,心肺正常。实验室检查;血自细胞计数77*l0~(9)/l,中性粒细胞0．33,淋巴细胞0．22,单核细胞0．11,淋巴瘤细胞0．34。血红蛋白130g/l。血小板192*10~(9)儿。左侧颈部巴结活检(病理871254)恶性林巴瘤(T细胞混合型),骨髓检查(87—72)骨髓增生明显活跃,原始细胞0．16,细胞圆形或椭圆形,直径14~18cm,核圆形,椭圆形或不规则形,核仁1~2个,染色质粗糙,浆蓝至深蓝色POX(一)。意见;淋巴肉瘤细胞性白血病。临床诊断:恶性淋巴瘤并淋巴肉瘤细胞性白血病。于1987年7月始行全身化疗COCP方案:(环磷酰胺2OOmg第1、3、5天,长春新碱2mg第1天,阿糖胞苷
Patient, male, 53 years old. Due to abdominal distension, the difference in a year increased one week in June 1987 to our hospital. Physical examination: The general condition is poor, anemia appearance, the left side of the neck, left and right side of the supraclavicular, groin can touch the swelling of several lymph nodes, diameter 2 to 8 cm, quality, normal heart and lung, abdominal bulging, liver ribs 5 to 6 cm, lOcm under the xiphoid process, and 4 cm under the ribs. Chest X-ray examination, normal heart and lung. Laboratory tests; blood counts 77*10~9/l, neutrophils 0.33, lymphocytes 0.22, monocytes 0.11, lymphoma cells 0.34. Hemoglobin 130g/l. Platelets 192*10~(9) children. Left cervical neck biopsy (pathology 871254) Malignant lymphoma (T-cell mixed type), bone marrow examination (87-72) Myeloproliferative activity was apparent, primitive cells 0.16, cells round or oval, diameter 14-18cm , nuclear round, oval or irregular shape, nucleoli 1 ~ 2, chromatin rough, pulp blue to dark blue POX (a). Advice; lymphosarcoma cell leukemia. Clinical diagnosis: malignant lymphoma and lymphosarcoma cell leukemia. The systemic chemotherapy COCP regimen began in July 1987: (Cyclophosphamide 2OOmg on days 1, 3, and 5, vincristine 2 mg on day 1, Ara-C