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患者,男,45岁,因结肠癌术后2月伴腹部包块10天入院。患者因脓血便行结肠癌根治术,术后病理为结肠类癌,给予5氟尿嘧啶750mg、卡铂50mg、丝裂霉素20mg腹腔热灌注5天化疗。术后2月发现锁骨上淋巴结肿大。查体:一般情况可,左锁骨上可触及直径约2cm的肿大淋巴结2枚,质中等、活动可、表面光滑、无压痛;心肺无异常;腹软,右中腹直肌可见长12cm手术痛疤痕,无压痛,肝脾不大,移动性浊音阴性;其余体检正常。初步诊断结肠癌术后腹腔淋巴结转移可能。行胃镜检查发现为胃恶性淋巴癌。给予5-FU+CF化疗1周期,但淋巴仍进行性增大,即行淋巴结活检,病理及免疫组化结果为LCA(+),CD_(45)RA(+),CD_(20)(+),CD_(45)RO(-),CD_3(-),SY(-),S_(-100)(-),病理诊断为中心B细胞床恶性淋巴瘤,可排除结肠癌转移。从上述检查结果患者存在消化道两个不同部位癌瘤。给FMC化疗方案加保
The patient, male, 45 years old, was admitted to the hospital for 10 days with abdominal mass in February after colon cancer surgery. Patients with colon cancer due to purulent blood surgery, postoperative pathological colon carcinoid, given 5-fluorouracil 750mg, carboplatin 50mg, mitomycin 20mg intraperitoneal hyperthermic 5-day chemotherapy. After February, supraclavicular lymph nodes were found. Physical examination: the general situation can be, the left clavicle can reach about 2cm in diameter swollen lymph nodes 2, medium quality, activity can be, smooth surface, no tenderness; no abnormal heart and lung; abdominal soft, right rectus abdominis visible 12cm long surgical pain Scars, no tenderness, small spleen and liver, mobility dullness negative; the rest of the physical examination was normal. Preliminary diagnosis of colon cancer after abdominal lymph node metastasis may be. Gastroscopy was found to be gastric malignant lymphoma. The patients were treated with 5-FU + CF chemotherapy for 1 cycle, but the lymph nodes were still progressively increased, ie, lymph node biopsy was performed. The pathological and immunohistochemical results were LCA (+), CD45RA (+), CD20 (+ , CD_ (45) RO (-), CD_3 (-), SY (-) and S_ (-100) (-) were detected in the patients with pathological diagnosis of B-cell bed malignant lymphoma. From the above test results, patients with two different parts of the digestive tract cancer. To FMC chemotherapy program plus insurance