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男,82岁。因反复左下肢肿痛溃烂流脓60余年、近2年加重入院。体查:左腹股沟可触及4个黄豆大的淋巴结。左小腿中上1/3外侧皮肤有约3×8.5cm之不规则溃疡窦道。局部皮肤红肿,色素斑散在分布,溃疡周围明显隆凸,皮肤表面之肉芽组织凹凸不平,有脓血样分泌物,奇恶臭,触之易出血。实验室检查:白细胞3.5×10~9/L中性77％,淋巴23％;血红蛋白100g/L,其余均无异常。X线照片示:左胫骨中上1/3骨干增粗,骨髓腔呈大片溶骨性骨质破坏,部份呈筛孔样溶骨性破坏状如“朽木”,
Male, 82 years old. Repeated left lower extremity ulceration and festering pus more than 60 years, nearly 2 years admitted to hospital. Physical examination: The left groin can reach 4 large lymph nodes of soybeans. There is an irregular ulcer sinus of approximately 3 x 8.5 cm in the upper 1/3 lateral skin of the left lower leg. Local skin irritation, pigment spots scattered in the distribution, ulcers around the obvious uplift, the skin surface of the granulation tissue uneven, with pus and blood-like secretions, strange odor, easy to touch the bleeding. Laboratory tests: Neutral 77% of white blood cells 3.5×10 9 /L, 23% of lymph; 100 g/L of hemoglobin, and no abnormality in the rest. X-ray photographs show that the middle and upper 1/3 of the left tibia are thickened, and the bone marrow cavity shows a large amount of osteolytic bone destruction, and some of them have a puncture-like osteolytic destruction like “Deadwood.”