论文部分内容阅读
一般推荐强的松为治疗血管免疫母细胞淋巴结病(AILD)的首选药物,近年不少学者认为联合化疗可能是更好的选择。本文报告一例64岁男性,因左腋下淋巴结肿大、肺炎入当地医院。经邻氯青霉素、先锋霉素、异烟肼及利福平等治疗无效,且气急、吞咽困难加重,转入檀香山部队总院。此时伴发热38.3℃,两颈广泛颈淋巴结肿大、颈部水肿、两腋下及左腹股沟淋巴结肿大、肝脾肿大、肺部听诊可闻哮鸣音,上下肢有凹陷水肿。胸片示右气管旁肿块,Hb10.1g/L,GOT、GPT、AKP轻度增高,血清蛋白电泳示多株丙种球蛋白血症,红细胞coombs试验(-),入院后不久腹股沟淋巴结活检示有恶性淋巴瘤的可能。由于气急及而部肿胀加重,便开始化疗。由于诊
It is generally recommended that prednisone is the drug of choice for the treatment of vascular immune lymphoblastoid disease (AILD). In recent years, many scholars believe that combination chemotherapy may be a better choice. This article reports the case of a 64-year-old man with a swollen lymph node in the left axilla and pneumonia in a local hospital. Treatment with o-chloropenicillin, cephalosporin, isoniazid, and rifampicin was ineffective, and dyspnea and dysphagia were aggravated and transferred to the Honolulu General Hospital. At this time with fever 38.3 °C, two neck wide neck lymph nodes, neck edema, bilateral infraorbital and left inguinal lymph nodes, hepatosplenomegaly, lung auscultation can be heard wheezing, depression in the upper and lower limbs. Chest radiograph showed right paratracheal mass, Hb10.1g/L, GOT, GPT, AKP slightly increased, serum protein electrophoresis showed multiple gamma globulinemia, red cell coombs test (-), shortly after admission showed in malignant lymph node biopsy The possibility of lymphoma. Due to acute urgency and increased swelling, chemotherapy was started. Because of the diagnosis