论文部分内容阅读
患者,男,52岁,以腹胀、纳差、消瘦8个月,在当地做胃镜检查及活检,病理为“十二指肠球部未分化腺癌”于1992年5月3日入院.既往健康,无消化道溃疡及肾脏病史.体检,一般情况差,消瘦,双侧巩膜无黄染,右侧腋下可触及l.0cm×1.5cm肿大淋巴结,质硬,边界清,活动,余表浅淋巴结未触及,右侧胸壁第10肋间腋中线皮下可触及2.0×2.5cm.包块,质硬无压痛,心肺未见异常,腹部隆起,稍韧,剑突及右侧腹部有压痛,并可触及3.0cm×4.0cm包块,肝脾未触及,腹水征阳性,双侧肾区无叩疼.入院后做B超检查,肝、胆、脾、胰腺均正常,腹腔内大血管周围布满数十个大小不等的低回声区,最大为7.3cm×4.5cm,边界清,有包膜回声,双侧肾脏大小形态正常,左右侧肾盂内各见6.1cm×2.2cm及8.1cm×2.2cm无回声区,结果示腹膜后腹腔淋巴结肿大
The patient, male, 52 years old, had abdominal distention, anorexia, and weight loss for 8 months. He underwent gastroscopy and biopsy in the local area. His pathology was “undifferentiated adenocarcinoma of the duodenal bulb.” He was admitted to hospital on May 3, 1992. Health, no history of peptic ulcers and kidney disease. Physical examination, poor general condition, weight loss, bilateral sclera without yellow stain, l.0cm x 1.5cm enlarged lymph nodes on the right armpit, hard, clear boundary, activity, I Superficial lymph nodes not touched, right side of the chest wall 10th subcostal midline subcutaneous palpable 2.0 × 2.5cm mass, mass hard without tenderness, no abnormal heart and lung, abdomen uplift, slightly tough, xiphoid and right abdomen with tenderness , And can touch 3.0cm × 4.0cm mass, liver and spleen is not touched, ascites positive, bilateral renal area without spastic pain. After admission to do B-ultrasound, liver, gallbladder, spleen, pancreas were normal, large intra-abdominal vessels There were dozens of hypoechoic areas of varying sizes, with a maximum of 7.3cm x 4.5cm. The borders were clear, there was an echo of the capsules, and bilateral kidneys were normal in size and shape. Each of the left and right pelvis showed 6.1cm x 2.2cm and 8.1. Cm×2.2cm echo-free zone, the result shows retroperitoneal abdominal lymphadenopathy