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患者女,60岁。以左侧腋窝肿物半年而收入院。查体:左腋窝皮下可扪及约3cm×5cm×5.4cm实质性肿块,边缘清,活动度小,表面有结节感及压痛,无血管杂音,皮肤红肿。B超示左腋窝实质性占位。左肩部正位片、胸部正侧位片均未见异常。血常规正常。肿块针吸涂片,镜下未发现瘤细胞。诊为左侧腋窝淋巴结炎。入院后经抗生素治疗7天,肿块无缩小,但皮肤红肿消失。即在硬膜外麻醉下切开左侧腋窝,将肿块及整个腋窝淋巴结及脂肪组织一并清扫切除。术后病理证实为恶性黑素瘤淋巴结转移。
Female patient, 60 years old. He was admitted to the hospital on the left axillary mass for six months. Physical examination: The left armpit can be subcutaneously palpable with a solid mass of approximately 3cm x 5cm x 5.4cm. The edge is clear, the activity is small, the surface has nodules and tenderness, no vascular noise, and the skin is red and swollen. B ultrasound shows the left armpit substantive occupation. No abnormality was found in the right shoulder anteroposterior radiograph and the chest positive radiograph. Normal blood. The tumor needles were smeared and no tumor cells were found under the microscope. Diagnosis of left axillary lymphadenitis. After being hospitalized for 7 days with antibiotics, there was no shrinkage of the mass, but the skin was red and swollen. That is, under the epidural anesthesia, the left axillary fossa was incised, and the mass and the entire axillary lymph node and adipose tissue were cleaned and removed. Postoperative pathology confirmed malignant melanoma lymph node metastasis.