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患者女,56岁,主诉易疲劳,气喘,体重减轻,小腿肿瘤。于1975年5月开始易疲劳、气喘,就诊发现有正细胞性贫血,胃X线检查于穹隆上部见阴影缺损,内窥镜检查见局部粘膜隆起,诊断“胃粘膜下肿瘤”。同年11月剖腹发现是脾脏错构瘤压迫所致。切除脾脏。肝活检正常。术后贫血对铁剂有反应,但未显著改善。翌年3月再次严重贫血,按胃溃疡治疗,1979年1月左胫骨下端出现肿瘤,某院整形科活检诊断为炎症性肉芽肿。2年间体重从56公斤降至45公斤。同年6月为进一步检查而入院。21岁时作子宫后屈矫正手术,36岁患肺结核。双亲为近亲结婚。入院时眼结膜贫血,心肺无特殊异常。肝、脾、淋巴结未及。左胫骨下端有鸡蛋大小的肿瘤,硬如骨,不能移动;无压痛、红肿。神经系统检查无异常。末梢血正细胞性
Female, 56 years old, complains of fatigue, asthma, weight loss, calf tumors. In May 1975 began to fatigue, asthma, treatment of anomalous cell anemia found, stomach X-ray examination in the dome see the shadow of the upper defect, endoscopic examination of local mucosal uplift, the diagnosis of “gastric submucosal tumor.” Caesarean section in November the same year found that spleen hamartoma oppression caused. Remove the spleen. Liver biopsy is normal. Postoperative anemia responded to iron but did not significantly improve. Severe anemia again in March the following year, according to the treatment of gastric ulcer, left tibia in January 1979 appeared tumor, biopsy of a hospital diagnosis of inflammatory granuloma. 2 years weight dropped from 56 kg to 45 kg. In the same year in June for further examination and admission. 21 years old for uterine flexion correction surgery, 36-year-old suffering from tuberculosis. Parents marry relatives. Conjunctival anemia on admission, no special heart and lung abnormalities. Liver, spleen, lymph nodes and time. Left tibia with egg-sized tumors, hard as bone, can not move; no tenderness, swelling. No abnormal neurological examination. Peripheral blood is cellular