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患者男,78岁。1996年4月20日因头昏乏力两天入院。头颅CT:硬膜下积液。经治疗症状减轻出院。半月后头昏加重再次入院。体检:BP 24/14kPa,浅表淋巴结不肿大,四肢肌力Ⅳ级,心肺(-)。各项实验室常规检查,胸片、肝脾B超等均正常。血沉60mm/h。入院后第10日起全身出现几十枚大小不等皮下结节,半球状隆起,表皮由微红转为暗红紫色,无压痛,边界欠清并逐渐增大。6月5日胸片:两侧中下肺小片状模糊阴影。经两次不同部位病检确诊为T淋巴细胞瘤。患者因全身衰竭于8月30日死亡。 讨论 T淋巴细胞瘤又称簟样霉菌病,原发于皮肤
Male patient, 78 years old. April 20, 1996 due to dizziness two days admitted to hospital. Head CT: Subdural effusion. The symptoms were relieved after discharge. Half a month after dizziness increased hospitalization again. Physical examination: BP 24 / 14kPa, superficial lymph nodes not enlarged, muscle strength of limbs grade Ⅳ, cardiopulmonary (-). The routine laboratory tests, chest X-ray, liver and spleen are normal. ESR 60mm / h. On the 10th day after admission, there appeared dozens of subcutaneous nodules ranging in size from the whole body to the hemispherical bulge. The epidermis turned from reddish crimson to dark red purple with no tenderness and the border was gradually cleared. June 5 chest X-ray: both sides of the middle and lower lung patchy fuzzy shadow. After two different parts of the disease diagnosed as T-cell lymphoma. Patient died of systemic failure on August 30. Discussion T lymphocytoma, also known as 簟 like mycosis, primary in the skin