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例1,男性,23岁,因会阴部麻木伴两便困难1月余入院。查体发现马鞍区浅感觉消失,双下肢腱反射消失,肌张力减遐,诊断为“马尾圆锥部肿瘤”。2个月后出现胸骨疼痛再次就诊,查周围血发现WBC210×10~9/L,Plt25×10~9/L,Hb87g/L;查骨髓象见有核细胞增生极度活跃,原始及早幼稚单核细胞占95%,其他各系统增生严重受抑,确诊为“急性单核细胞性白血病伴马昆圆锥部浸润”,先后接受多种方案化疗,同时鞘内注射氨甲喋呤(MTX)并行马尾圆锥局部放疗,但未能获得缓解,于发病后9个月死亡。例2,男性,17岁,因咳嗽伴左侧胸痛及低热20余天、夜间不能平卧3d入院。体检皮肤粘膜未见出血点及淤斑,肝、脾及全身浅表淋巴结不肿大,胸骨无压
Example 1, male, 23 years old, due to perineal numbness with two difficulties more than 1 month admission. Examination found that the saddle area shallow feeling disappeared, double lower extremity tendon reflex, muscle tension minus ya, diagnosed as “cauda equina tumor.” 2 months after the occurrence of sternal pain again treatment, check the surrounding blood found WBC210 × 10 ~ 9 / L, Plt25 × 10 ~ 9 / L, Hb87g / L; check bone marrow see nucleated cell hyperplasia extremely active, Cells accounted for 95% of the other system hyperplasia was severely suppressed, diagnosed as acute monocytic leukemia with Marquise condyloma infiltration has received a variety of programs of chemotherapy, while intrathecal methotrexate (MTX) parallel cauda equina local radiotherapy , But failed to get relief and died at 9 months after onset. Example 2, male, 17 years old, due to cough with left chest pain and fever more than 20 days, at night can not lie 3d hospital. Physical examination of skin and mucous membrane no bleeding spots and ecchymosis, liver, spleen and superficial lymph nodes of the body is not enlarged, no pressure in the sternum