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患者男,64岁。因咳嗽、胸痛、枕部下颌部及双季肋部多个无痛性结节半年于1992年5月4日入院。伴不规则发热(T<38℃),乏力抗炎治疗效果差。既往有肺结核病史7年及类风湿性关节炎病史6年。查体:T37℃,BP16.5/10kPa,心肺腹部未见异常。枕部、下颌部及双季肋部可触及多枚大小不等结节,最大者2×2cm,质硬,无压痛,边界清楚,不活动。四肢小关节呈类风湿样改变。X线胸片示:双肺不规则密度增高影,多考虑肺间质纤维化改变。血沉125mm/lh,类风湿因子(+)。血WBC7.0～18×10~(?)/L,N 0.50～0.70,L 0.30～0.50。肿块病理检查:结节性脂膜类。经激素及抗生素治疗,症状消失,痊愈出院。讨论:
Patient male, 64 years old. Due to cough, chest pain, occipital mandibular and double sequel multiple painless nodules in the hospital for six months on May 4, 1992. With irregular fever (T <38 ℃), weak anti-inflammatory treatment is poor. Past history of tuberculosis 7 years and history of rheumatoid arthritis 6 years. Physical examination: T37 ℃, BP16.5 / 10kPa, no abnormal heart-lung abdomen. Occipital, mandibular and bi-quarter ribs can reach a number of sizes ranging from nodules, the largest 2 × 2cm, hard, no tenderness, the boundary is clear, inactive. Limb joints showed rheumatoid change. X-ray showed: irregular lung density increased shadow, more consideration of interstitial lung fibrosis. ESR 125mm / lh, rheumatoid factor (+). Blood WBC 7.0 ~ 18 × 10 ~ (?) / L, N 0.50 ~ 0.70, L 0.30 ~ 0.50. Mass examination: nodular lipid membranes. Hormones and antibiotics, the symptoms disappeared, discharged. discuss: