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例1:男,52岁。1个月来持续发热,伴胸痛、轻微干咳,用抗生素、激素治疗疗效不显,查血沉95mm/h,摄片疑肺结核而转来我院。既往无结核病等接触史。查体:体温38.5℃,贫血貌。皮肤、粘膜苍白,无出血点或淤斑。表浅淋巴结不肿大,口腔、咽部粘膜无溃疡,扁桃体无肿大。胸骨有压痛,双肺呼吸音粗,肺底闻及湿罗音。肝脏肋下2cm。B超示脾肿大。Hb30～42g/L,WBC16.8～27.2×10~9/L,中性0.48～0.52,淋巴0.48～0.58。痰浓缩未查到结核菌。入院第3天行骨髓检查,骨髓增生极度活跃,原早粒0.80,后期细胞较少,巨核细胞以原幼为主;血片原早粒0.70,血小板少见。确诊为急性粒细胞性白血病。 例2:女,40岁。因胸痛、全身乏力不适半
Example 1: Male, 52 years old. 1 month to continue fever, with chest pain, mild dry cough, with antibiotics, hormone therapy is not significant, check the blood sedimentation 95mm / h, suspected lung tuberculosis and transferred to our hospital. Previous history of exposure to tuberculosis. Physical examination: body temperature 38.5 ℃, anemia appearance. Skin, mucous membrane pale, no bleeding spots or ecchymosis. Superficial lymph nodes are not swollen, oral, pharyngeal mucosa without ulcer, tonsil no swelling. Sternal tenderness, breath sounds coarse lungs, lungs smell and wet rales. Liver ribs 2cm. B ultrasound showed splenomegaly. Hb30 ~ 42g / L, WBC16.8 ~ 27.2 × 10 ~ 9 / L, neutral 0.48 ~ 0.52, lymph 0.48 ~ 0.58. Condensed sputum has not been found in TB. On the third day after admission, bone marrow examination was performed. Myeloproliferation was extremely active. The progenitor grain was 0.80 and the late cells were fewer. The megakaryocytes were mainly young and juvenile. Confirmed as acute myeloid leukemia. Example 2: Female, 40 years old. Due to chest pain, malaise discomfort half