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岚哥岚嫂说病例第2季第05期(病例部分)

岚哥岚嫂说病例第2季第05期(病例部分)

作者: 岚逸筠篁 | 来源:发表于2016-09-28 21:01 被阅读18次

    A 56-year-old man presents to his physician complaining of severe fatigue. He began to feel increasingly tired about 6 months ago, but believes that his fatigue has been worsening over the past 3 weeks. He also notes that he has had a nonproductive cough for about 2 weeks,and has experienced several episodes of drenching night sweats. On examination, he has several large bruises on his extremities but recalls no injuries. Abdominal examination reveals massive enlargement of both the liver and the spleen, without any lymphadenopathy.Laboratory tests show:WBC count 12,000/mm3, Neutrophils 58%, Eosinophils 7%, Lymphocytes 30%, Monocytes 0%, Basophils 5%, RBC count 3.0/mm3, Hemoglobin 7.5 mg/dL, Platelet count 18,000/mm3, Peripheral blood smear reveals irregular nuclei and cell membranes, as well as cytoplasmic projections.

    Questions:

    What is the patient's most likely diagnosis?
    What is the treatment to the disease?

    本次病例中:一名56岁的男性患者向医生主诉自觉重度疲乏,而且疲乏已持续6个月,自觉加重3周。患者主诉在无诱因下出现长达2周的咳嗽,并且经常被夜汗彻底湿透。体检中,患者四肢存在散在的大面积淤青,但是患者并未有外伤史。腹部触诊发现患者肝脏和脾脏非常巨大,但未能发现淋巴结肿块。
    实验室检查结果如下:白细胞 12,000/mm3,中性粒细胞 58%,嗜酸性粒细胞 7%,淋巴细胞 30%,单核细胞 0%,嗜碱性粒细胞 5%,红细胞 3.0/mm3,血红蛋白 7.5 mg/dL,血小板 18,000/mm3,血液涂片镜检中发现患者细胞核和细胞膜呈不规则状,胞浆周边不规则突起样。

    问题:

    1、患者最可能的诊断是什么?
    2、对于该疾病的治疗方式有哪些?

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