患者,女性,24岁。主诉胸闷4月,2周来加重伴咳嗽,胸片示左侧胸腔大量积液。于1986年1月14日入本院治疗。胸水示渗出性,2次癌细胞阴性。经抗痨治疗1月,胸水一度减少后又增加至中等量。此时胸片见左肺门外方有一肿块,性质不明,二维超声心动图示少量心包积液,2月21日转血液内科进一步检查。体检;T38℃,呼吸急促,面色苍白。左侧颈部及左颌下有一枣核大小的淋巴结。全身皮肤结节约80个(入院时仅数个),大小为1×1～2×3cm、质硬、表面光滑无压痛、左背部自第五肋间以下叩诊浊音,呼吸音消失,腹部微隆、肝肋下0.5cm、脾肋下3cm,质中、无压痛、无移动性浊音、骨髓穿刺液涂片,有核细胞增生较活跃,分类原+幼淋66.5％,淋巴18.5％。骨髓活检及皮肤结节活检,示恶性淋巴瘤。外周血及 Patient, female, 24 years old. Chief complaint chest tightness in April, 2 weeks with aggravated cough, chest X-ray showed a large effusion in the left chest. On January 14, 1986 into the hospital for treatment. The pleural fluid showed exudative, and the cancer cells were negative 2 times. After one month of anti-spasmodic treatment, pleural fluid was once reduced and then increased to a moderate amount. At this time, the chest radiograph showed a mass outside the left hilum, and the nature was unknown. A two-dimensional echocardiogram showed a small amount of pericardial effusion. On February 21st, he went to the Department of Hematology for further examination. Physical examination; T38 °C, shortness of breath, pale. There is a date-sized lymph node in the left neck and left mandible. Total body skin knots save 80 (only a few when admitted to hospital), the size of 1 × 1 ~ 2 × 3cm, hard, smooth surface without tenderness, left back from below the fifth intercostal percussion dull, breath sounds disappear, abdominal microlong , Liver ribs 0.5cm, spleen and ribs 3cm, qualitative, no tenderness, no moving dullness, bone marrow puncture fluid smear, nucleated cell proliferation is more active, classification original + young 66.5%, lymphatics 18.5%. Bone marrow biopsy and skin nodule biopsy showed malignant lymphoma. Peripheral blood and