论文部分内容阅读
患者男,36岁,因反复咳嗽2月,咳血丝痰1月于1989年5月2日入院。2年前因全身皮肤黄染,住我院诊断为自身免疫性溶血性贫血,一直服强的松治疗。体查:无发热,心肺(-),肝脾肋下未触及。胸片及CT均提示:左上肺直径3.5cm肿块,肺门淋巴结肿大。考虑为左上肺癌肺门淋巴结转移。入院后,先后出现右4、5前肋局部小指头大隆起,压痛。颈、前胸及臀部多个拇指头大脓肿,红、热。右乳房6×8cm皮下结节,硬,压痛,活动。头痛复视,颈抵抗。颅CT(-)。胸片:右4、5肋骨不规则溶骨破坏,右胸腔少量积液。脓肿及皮下结节穿刺液涂片见大量成团小圆形孢子。CSF:压力2.93kPa,蛋白2.8g/L,氯化物114mmol/L,多次涂片墨汁染色及
Male patient, 36 years old, due to repeated cough in February, coughing sputum January January 2, 1989 admission. 2 years ago due to body yellow skin dye, live in our hospital diagnosed with autoimmune hemolytic anemia, has been a strong prednisone treatment. Physical examination: no fever, cardiopulmonary (-), liver and spleen ribs did not touch. Chest radiograph and CT tips: 3.5cm diameter left upper lung mass, hilar lymph nodes. Consider hilar lymph node metastasis for upper left lung cancer. Admitted to the hospital, there has been the right 4,5 before the local small finger big bulge, tenderness. Neck, chest and buttocks multiple thumb big abscess, red, hot. Right breast 6 × 8cm subcutaneous nodules, hard, tenderness, activity. Headache diplopia, neck resistance. Cranial CT (-). Chest radiograph: irregular 4,5 rib rib destruction, right chest a small amount of fluid. Abscess and subcutaneous nodules puncture fluid see a large number of groups into small round spores. CSF: pressure 2.93kPa, protein 2.8g / L, chloride 114mmol / L, multiple smear ink staining and