病例报告例1 患者男,24岁,上腹痛11月,皮肤变黑4个月入院。81年9月起,饭前上腹胀痛,进食后减轻,无反酸嗳气,当地医院对症治疗,时好时差。后感食纳差,疼痛失去规律。82年4月钡餐造影及胃镜检查,诊断为“胃溃疡”,服药1个月后腹痛不明显。此后陆续出现颈部,四肢关节处,脐周,腋窝等皮肤皱折处变黑,粗糙,渐扩散至全身,微痒。当年7月转北京,各医院诊治,曾考虑为“阿狄森氏病”,后经皮肤活检,病理诊断为“黑棘皮病”。8月23日我院胃镜检查及活检证实为胃癌。 1982年9月18日手术,见胃窦区肿瘤,胃周及腹腔淋巴结广泛转移,少量乳糜腹水。行姑息性胃次全切除及胃空肠吻合术。术后病理报告为胃窦小弯侧溃疡型低分化腺癌,肿块7×5×1.5cm大小,肿瘤浸润胃壁全层,癌旁胃壁各层及下切缘多数淋巴管中有癌栓,淋巴腺转移,小弯侧7/7.部分融合成瘤块,大弯侧 Case Report Example 1 A male patient, 24 years old, suffered abdominal pain for 11 months, and his skin became dark for 4 months. Since September of the year 81, the upper abdomen has been pained before meals, relieved after eating, and has no acid reflux. Local hospitals are symptomatic and have a good time difference. After eating anorexia, pain loses regularity. In April of 82 years, barium meal and gastroscopy were diagnosed as “stomach ulcer”. After 1 month of medication, abdominal pain was not obvious. Since then, necks, joints at the extremities, umbilical cords, axillary fossa and other skin creases have turned black, rough, and gradually spread to the entire body, slightly itch. In July of that year, the hospital was transferred to Beijing. The hospitals were diagnosed and treated as “Addison’s disease.” After skin biopsy, the pathological diagnosis was “black acanthosis.” On Aug. 23, gastroscopy and biopsy in our hospital were confirmed as gastric cancer. September 18, 1982 surgery, see gastric antrum area tumor, gastric and abdominal lymph node metastasis, a small amount of milky ascites. Palliative subtotal gastrectomy and gastrojejunostomy were performed. The postoperative pathology report was anteroacute ulcerated type poorly differentiated adenocarcinoma of the gastric antrum. The size of the tumor was 7×5×1.5 cm. The tumor infiltrated the entire layer of the stomach wall. The tumors were located in the adjacent lymph nodes of the adjacent gastric cancer wall and the lower margin. Metastasis, small curvature side 7/7. Partial fusion into tumor mass, large curvature side