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患者女,57岁,因进行性呼吸困难和声音嘶哑2个月入院。体检发现全身多部位压痛,皮肤红斑,四肢和右眼睑有皮下结节,无淋巴结病变和肝脾肿大。实验室检查血沉11mm/h;红细胞比积37.3%;白细胞6400/mm~3,其中含6%异常淋巴细胞,44%淋巴细胞,48%中性粒细胞和单核细胞;血小板计数29500/mm~3。末梢血中异常淋巴细胞中等大小,胞浆量少。大量异常淋巴细胞内可见特异性核卷曲和核分叶,血清抗ATL抗体通过直接免疫荧光法检测为阳性。入院时末梢血和入院后连续腹水检测证实大部分淋巴细胞表面标记为OKT3阳性(73%和87%),余依次为OKT4阳性(44%和86%)和OKT8阳性(25%和10%)。鼻咽部检查和X光片证实在鼻
Female, 57, was hospitalized for 2 months due to progressive dyspnea and hoarseness. Physical examination found multiple parts of the body tenderness, skin erythema, limbs and right eyelid subcutaneous nodules, no lymphadenopathy and hepatosplenomegaly. Laboratory tests ESR 11mm / h; hematocrit 37.3%; white blood cells 6400 / mm ~ 3, which contains 6% of abnormal lymphocytes, 44% of lymphocytes, 48% of neutrophils and monocytes; platelet count 29500 / mm ~ 3. Abnormal peripheral blood lymphocytes in the medium size, less cytoplasm. A large number of abnormal lymphocytes can be seen within the specific nuclear curly and nuclear lobes, serum anti-ATL antibodies by direct immunofluorescence test was positive. Peripheral bloods at admission and continuous ascites testing after admission confirmed that most of the lymphocyte surface markers were OKT3 positive (73% and 87%), followed by OKT4 positive (44% and 86%) and OKT8 positive (25% and 10% . Nasopharyngeal examination and X-ray confirmed in the nose