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作者报告1例37岁女性患者,因短期发热入院检查。腋窝及颈部可扪及小淋巴结,肝脾不大,无皮损,左肺叩浊,呼吸音低。Hb12g%,血小板27万/mm~3,白细胞28000/mm~3,小淋巴细胞76%,大淋巴细胞占11%,未见异形淋巴细胞。骨髓抽吸淋巴细胞占30%。胸部X线及CT检查见前纵膈有一大肿块,心脏稍右移,肿块已与左胸壁粘连。支气管镜检发现左主支气管有腔外性压迫。腋、颈及纵膈淋巴结活检正常。纵膈肿块细针穿刺抽吸细胞学检查不能定论。手术取部分瘤组织作病理检查,诊断为淋巴细胞为主型胸腺瘤。免疫学检查表明:治疗前外周血淋巴细胞92%为T细胞,B细胞仅占3%,T4/T8为6.3。淋巴结T4/T8为17.4。瘤组织内无B细胞,T4/T8为4.15。治疗后外周血淋巴细胞由原来的18
The authors reported a case of a 37-year-old female patient admitted for short-term fever. Axillary and cervical lymph nodes can be small and small, liver and spleen is not, no skin lesions, left lung turbidity, low breath sounds. Hb12g%, platelets 270,000/mm~3, WBC 28000/mm~3, 76% of small lymphocytes, large lymphocytes accounted for 11%, no heteromorphic lymphocytes. Bone marrow aspirate lymphocytes accounted for 30%. Chest X-ray and CT examination showed a large mass in the anterior mediastinum, with the heart moving slightly to the right and the mass already adhering to the left chest wall. Bronchoscopy revealed extraluminal compression of the left main bronchus. Lymph nodes, neck, and mediastinal lymph node biopsy were normal. Mediastinal fine needle aspiration cytology can not be conclusive. Some of the tumors were taken for pathological examination and diagnosed as lymphocyte-predominant thymomas. Immunological examination showed that before treatment, 92% of the peripheral blood lymphocytes were T cells, B cells accounted for only 3%, and T4/T8 was 6.3. The lymph node T4/T8 was 17.4. There were no B cells in the tumor tissue, and T4/T8 was 4.15. Peripheral blood lymphocytes from the original 18 after treatment