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患儿 男,4岁。颈部两侧无痛性对称性肿胀2周,持续发热10天,于1993年11月6日入院。7个月前患“腮腺炎”。查体:体温38℃,脉搏100次,呼吸26次。贫血貌,皮肤无皮疹及出血点。双侧腮腺对称性肿大3×3×1cm,质韧,腮腺管口无渗出。双侧颌下腮腺肿胀1.5×1.5×1cm,质韧,均无触痛。口腔粘膜干燥。心肺未见异常。腹软,肝肋下5cm,剑突下4.5cm,质韧,脾未触及。实验室检查:血红蛋白82g/L,白细胞4×10~9/L,中性粒细胞0.54,淋巴细胞0.42,单核细胞0.04,血小板18×10~9/L。末梢血未见原始或幼稚白细胞。骨髓检查:原始+幼稚淋巴细胞0.855,部
The boy is 4 years old. Sympathetic swelling on both sides of the neck for 2 weeks, fever continued for 10 days, and was admitted to hospital on November 6, 1993. 7 months ago suffering from “mumps.” Physical examination: body temperature 38°C, pulse 100, breathing 26 times. Anemic appearance, skin without rash and bleeding points. Bilateral parotid symmetry swelling 3 × 3 × 1cm, quality tough, parotid gland without leakage. Bilateral submaxillary salivary gland swelling 1.5 × 1.5 × 1cm, quality tough, no tenderness. Oral mucous membranes are dry. No abnormalities in heart and lung. Soft abdomen, 5 cm below the ribs, 4.5 cm below the xiphoid, tough, spleen not touched. Laboratory examinations: hemoglobin 82 g/L, leukocytes 4 x 10-9/L, neutrophils 0.54, lymphocytes 0.42, monocytes 0.04, platelets 18 x 10-9/L. No peripheral blood or primordial white blood cells were seen. Bone marrow examination: original + immature lymphocytes 0.855, ministry