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男性,59岁,1985年起纳差,乏力;1987年初觉头昏,心悸,同年7月出现牙龈糜烂,面色苍白,于8月30日转入我院。体格检查:贫血貌,消瘦,体温38.5℃,全身皮肤无出血点或淤斑,颌下淋巴结花生米大伴触痛,巩膜无黄染,牙龈有小溃疡面,无溢脓出血,胸骨有压痛,心肺无异常发现,肝脾均未触及。实验室检查:末梢血中出现粒及单核幼稚细胞、有核红细胞、小巨核及巨核细胞碎片;骨髓有核细胞增生明显活跃,红、粒、单、巨核四系细胞恶性增生。红系增生活跃,以原始和早幼红细胞增生为主,可见巨幼样变及多核红细胞,核分裂明显增多。粒系仅占骨
Male, 59 years old, anorexia since 1985, fatigue; early 1987, dizziness, palpitations, gum erosion in July the same year, pale, on August 30 into our hospital. Physical examination: anemic appearance, weight loss, body temperature 38.5 ℃, systemic skin bleeding or ecchymosis, submaxillary lymph node peanuts with tenderness, scleral no yellow dye, gingival ulcers, no overflow pus bleeding, sternal tenderness, No abnormal heart and lung, liver and spleen were not touched. Laboratory tests: peripheral blood cells and mononuclear immature cells, nucleated erythrocytes, megakaryocytes and megakaryocyte fragments; bone marrow nucleated cell proliferation was active, red, granular, single, megakaryocytic malignant hyperplasia. Erythroid hyperplasia is active, with the original and premature erythroblastic hyperplasia, visible juvenile and multicellular red blood cells, mitotic increased significantly. Granules account for only bone