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患者女,57岁。不规律上腹痛4年加重1个月行胃镜检查,见胃窦部火山口样溃疡,胃壁僵硬,取活检病理诊断为“胃腺癌”。1992年6月入院。查体:无贫血貌,浅表淋巴结无肿大,上腹未及包块,肛诊(一).胸片,腹部B超检查未见异常。于6月15日在持续硬膜外麻醉下行手术治疗。术中见胃窦部溃疡型肿物4.0cm未浸透浆膜,幽门上下可及多个直径1.0cm肿大淋巴结,按胃癌行根治术。术后病理诊断;胃窦部非何杰金氏恶性淋巴瘤,B淋巴细胞来源,淋巴结无转移。术后恢复好,给予COAP方案化疗。随访2年无复发。1993年9月因右肩部复发性肿物再次入院。入院前4个月因右肩部肿物于外院按皮脂腺囊肿给予切除,未行病理检查,术后2个月
The patient is 57 years old. Irregular upper abdominal pain was aggravated by gastroscopy 4 years after aggravation for 1 month. See gastric antrum crater-like ulcers, stomach stiffness, biopsy pathological diagnosis of “gastric adenocarcinoma.” Admitted to hospital in June 1992. Physical examination: no anemia appearance, superficial lymph nodes without enlargement, no abdominal mass, and anal diagnosis (I). Chest radiographs and abdominal ultrasound examinations were normal. On June 15th, surgical treatment continued under epidural anesthesia. During the operation, the gastric antrum ulcer mass 4.0cm was not immersed in the serosa, and the pylorus was able to reach several lymph nodes with a diameter of 1.0cm. According to the radical gastrectomy for gastric cancer. Postoperative pathological diagnosis; gastric antrum non-Hodgkin’s lymphoma, B lymphocyte source, no lymph node metastasis. Recovery was good after surgery, given COAP chemotherapy. Follow-up for 2 years without recurrence. In September 1993, a recurrent tumor of the right shoulder was admitted again. 4 months before hospitalization, the right shoulder mass was removed in a sebaceous cyst in the outer hospital. No pathological examination was performed. 2 months after surgery