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1 病例报告女,29岁。因闭经,皮肤色素沉着,毛发增多4月,纳差,乏力2月入院。查体:营养差,贫血貌。左锁骨上米粒大淋巴结2枚,无触痛。腹软,肝、脾未触及。周身皮肤粗糙,汗毛浓密,发际处毛发增多,有小胡须。颈部、肘部及皮肤皱摺处色素沉着明显。三大常规,血、尿淀粉酶,肝、肾功能正常。粪隐血阴性。血皮质醇测定:08:00 22μg/L,17:00 23μg/L,地塞米忪1 mg试验,次晨血浆皮质醇不受抑制。B超发现腹膜后淋巴结融合成块。子宫增大,肝、脾、胰腺未见异常。内镜检查:浅表性胃炎,贲门下小弯侧溃疡病恶变。病理报告:腺癌Ⅱ级。涂片找
1 Case report Female, 29 years old. Due to amenorrhea, skin pigmentation, hair increased in April, anorexia, fatigue admitted to hospital in February. Physical examination: poor nutrition, anemia appearance. The left supraclavicular rice has 2 large lymph nodes and no tenderness. Soft abdomen, liver, spleen did not touch. The whole body has rough skin, dense hair, hair growth at the hairline, and small beards. Skin pigmentation is evident at the neck, elbows, and skin creases. Three conventional, blood, urine amylase, normal liver and kidney function. Fecal hidden blood negative. Blood cortisol determination: 08:00 22 μg/L, 17:00 23 μg/L, dexamethasone 1 mg test, plasma cortisol was not inhibited the next morning. B-ultrasound found that the retroperitoneal lymph nodes became fused. The uterus was enlarged and no abnormalities were found in the liver, spleen, and pancreas. Endoscopy: superficial gastritis, cricopharyngeal ulcers malignant transformation. Pathology report: Adenocarcinoma II. Smear search