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[病例] 男,68岁。因进行性纳差,消瘦4个月,皮下结节1个月入院。查体:体温36.8℃,血压110/60mmHg,一般状况差,贫血貌,胸壁、右肋缘下、腹壁、右大腿后皮下可触及数个约黄豆至红枣大小的结节,质硬,无压痛,与周围组织无粘连,局部无红肿,皮温正常。双侧锁骨上、右腋窝可触及十余个约黄豆大小之淋巴结,质硬、无压痛,部分融合且与周围组织粘连。心肺无异常,肝脾肋下未触及,双下肢无水肿。X线胸片示右侧前第一肋间可见片状密度增高阴影,性质待查。B超:①肝右后叶下方实性包块,考虑来自腹膜后;②左肾轻度积水;③右大腿后、右肋缘下、脐旁皮下实性包块。印象:①腹膜后恶性肿瘤;②肺转移癌;③淋巴结转移癌;④皮下转移癌。血常规:白细胞
[Case] Male, 68 years old. Due to progressive anorexia, weight loss was 4 months and subcutaneous nodules were admitted to the hospital for 1 month. Physical examination: body temperature 36.8 °C, blood pressure 110/60mmHg, poor general condition, anemia appearance, chest wall, right costal margin, abdominal wall, right thigh back subcutaneously can reach several nodules about the size of soybean to jujube, hard, no tenderness , No adhesion with the surrounding tissue, no local swelling, skin temperature normal. Bilateral supraclavicular and right axillary fossa can reach more than ten lymph nodes of about the size of soya beans, which are hard and tender, partially fused and adhere to surrounding tissues. No abnormalities in heart and lung, liver and spleen did not touch the ribs, no lower extremity swelling. The chest X-ray film shows that the first intercostal space on the right side of the first intercostal space shows increased shadow density, and the nature is unknown. B-mode ultrasound: 1 The solid mass below the right posterior lobe of the liver is considered to be from the retroperitoneum; 2 the left kidney is slightly watery; 3 is behind the right thigh, the right costal margin, and the subumbilical lateral solid mass. Impression: 1 retroperitoneal malignant tumor; 2 metastatic lung cancer; 3 metastatic lymph node; 4 subcutaneous metastatic cancer. Blood routine: WBC