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患者男,54岁,发热咳嗽伴颈部包块2个月于1992年9月21日入院、缘于2个月前不明诱因发热伴咳嗽,以夜间尤甚.院外接感冒治疗效果不佳.1个月前感颈部钝痛,并牵扯头痛,以夜间为重,持续1～2小时,自行缓解,稍感心慌、胸闷、气促.颈部扪及数个花生米大小之包块,轻压痛,未引起重视,病情逐日加重而来院.既往史无特殊.查体:慢性消瘦重病容,贫血貌,皮肤蜡黄伴有抓痕.两侧颈部、锁骨上窝、腹股沟可扪及多个花生米至鸽蛋大小之淋巴结,表面光滑,边缘清楚,无粘连,轻压痛,质硬.双肺阴性,心率快,律齐,心尖区可闻及Ⅲ级吹风样收缩期杂音,不传导.腹软,肝肋下1cm.质软.脾肋下3cm,质中等,无压痛.X线示:双上肺纤维灶.骨髓结果:粒细胞系统分叶核粒细胞比例明显增高,轻度贫血骨髓象.心电图示:窦性心律,T波在Ⅱ、avF双向,
Male patient, 54 years old, cough with fever and neck mass 2 months admitted on September 21, 1992, due to unknown causes of fever 2 months ago with cough, especially at night. 1 month ago, neck dull pain and headache, heavy at night, sustained 1 to 2 hours, to ease, a little feeling of palpitation, chest tightness, shortness of breath. A few peanut neck palpable mass of mass, Mild tenderness, did not pay attention to, the condition increased day by day from the hospital. Previously history has no special. Physical examination: chronic weight loss and severe disease, anemia, skin wax yellow with scratches on both sides of the neck, supraclavicular fossa, inguinal palpable and more A peanut to pigeon egg size of the lymph nodes, the surface is smooth, clear edges, no adhesions, tender tenderness, hard lung negative, fast heart rate, law Qi, apex area can be heard and Ⅲ grade hair-style systolic murmur, no conduction Abdominal soft, liver ribs 1cm. Soft. Spleen ribs 3cm, medium quality, no tenderness .X ray showed: double upper lung fibrosis .Bone marrow results: Granulocyte system leaves the nucleus granulocyte ratio was significantly increased, mild Anemia bone marrow.Electrocardiogram: sinus rhythm, T wave in Ⅱ, avF bidirectional,