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武汉：一患者淋巴结莫名肿大 竟是艾滋病捣鬼
2011年04月15日10:16 来源：人民网-社会频道
人民网武汉4月15日电 淋巴结莫名肿大，怎么也查不出病因，最终意外发现病因竟是艾滋病。
37岁女子王某无明显诱因全身多处淋巴结出现肿大，先后去多家医院检查，结核、风湿、白血病都排除了，却找不到诊断为肿瘤的证据。一个月前，她入住广州军区武汉总医院肿瘤科，先是做了左颈部淋巴结活检，病理报告是淋巴结反应性增生。后又做了右颈部淋巴结活检，病理报告还是增生。一个月来，王某逐渐消瘦，还伴有低热、水肿等症状。为了给患者补充白蛋白，医生在输血前给她作了乙肝、梅毒、艾滋病、丙肝4项检查。没想到，这个普通的检查竟然揪出了王某淋巴结肿大的“元凶”——艾滋病。经追问王某在10年前曾有输血史。
对此，湖北省抗癌协会癌症康复与姑息治疗专业委员会副主任委员、广州军区武汉总医院肿瘤科主任高建飞教授介绍，临床上经常碰到不明原因的淋巴结肿大患者，尤其以颈部、腋窝和腹股沟最为常见。淋巴结肿大最常见的原因是炎症、结核、淋巴瘤、转移性癌等。其中，炎症引起的淋巴结肿大通常呈现出红、痛、热的特点，虽然起病快，但经抗炎后肿块消退；结核引起的淋巴结肿大通常病程长，呈串状，质中等，可活动，无压痛，可互相粘连成团；淋巴瘤导致的淋巴结肿大多为无痛性，进行性增大，质硬，活动度差，常伴有发热、肝脾肿大、消瘦乏力等症状；而淋巴结转移性癌引起的肿块则通常逐渐增大，质硬，活动度差。
高建飞教授说，除上述原因之外，艾滋病也是淋巴结肿大常见的原因之一，常表现为持续性全身淋巴结肿大，可发生在艾滋病的各期。所有艾滋病毒感染者都有潜伏期，此期患者可无任何临床症状，但部分患者可出现全身淋巴结肿大，这可能是唯一的指征。临床表现一般为腹股沟以外两个或多个位置的淋巴结肿大，持续时间最短3-6个月，淋巴结活组织检查为滤泡增生。体检常发现对称、可活动、有弹性的淋巴结，大小为0.5-2cm，常无疼痛及触痛。最常见的部位为颈部及腋窝淋巴结。
高建飞教授提醒，发现无明显原因的淋巴结肿大患者，一定要仔细追问性生活史和输血、献血史。（张志峰、刘宇、章必成）
艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复
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| 图示∶2010年12月即将出版的《中国特色医疗金鉴》登载的刘君主任及其机构 |
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Wuhan: an inexplicable lymph nodes in patients with AIDS was actually mischief
At 10:16 on April 15, 2011 Source: People's Network - Social Channel
April 15 People's Daily Xinhua Wuhan inexplicable swollen lymph nodes, how can not find the cause, the end was actually surprised to discover the cause of AIDS.
Wang, 37-year-old woman was no obvious incentive to the whole body appears in various lymph nodes, has to go more than a hospital, tuberculosis, rheumatism, leukemia are excluded, but can not find evidence of a diagnosis of cancer. A month ago, she was admitted to the Guangzhou Military Region, Wuhan General Hospital of Oncology, first, do a left cervical lymph node biopsy, the pathological report was lymph node reactive hyperplasia. Then do the right cervical lymph node biopsy, pathology or hyperplasia. Month, Wang gradual weight loss, accompanied by fever, edema and other symptoms. To supplement of albumin to patients, doctors gave her before transfusion hepatitis B, syphilis, AIDS, hepatitis C 4 inspection. Unexpectedly, the normal checks Wang lymph nodes even uncovered the "culprit" - AIDS. Wang, 10 years ago by questioning had blood transfusion.
In this regard, Hubei Cancer Society Cancer Rehabilitation and Palliative Care Committee of Vice Chairman, Wuhan General Hospital of Guangzhou Military Region, director of Professor Gao Jianfei introduced clinically frequently encountered in patients with unexplained swollen lymph nodes, particularly in the neck, armpits and the groin is most common. Lymph nodes is the most common cause of inflammation, tuberculosis, lymphoma, metastatic cancer. Which is usually inflammation of the lymph nodes showing a red, pain, heat characteristics, although the onset of fast, but after the tumor regression by anti-inflammatory; TB is usually caused by swollen lymph nodes, longer duration, was string-like, medium quality can be activities, no tenderness, adhesion each other into a group; lymphoma, lymph nodes, mostly caused by painless, progressive increases, hard, poor activity, often accompanied by fever, hepatosplenomegaly, weight loss and fatigue and other symptoms; The tumor caused by metastatic cancer is usually increased gradually, hard, poor activity.
Professor Gao Jianfei that, in addition to the above reasons, AIDS is also a common cause of swollen lymph nodes, usually manifested persistent generalized lymphadenopathy, AIDS can occur in each period. All HIV infections have incubation period, this period may be no clinical symptoms of patients, but some patients with systemic lymph node enlargement can occur, which may be the only indication. Clinical manifestations usually two or more locations outside the inguinal lymph node enlargement, the shortest duration of 3-6 months, lymph node biopsy as follicular hyperplasia. Physical examination often find symmetrical, movable, flexible lymph nodes, size of 0.5-2cm, often without pain and tenderness. The most common sites of neck and axillary lymph nodes.
Professor Gao Jianfei reminder, found no obvious cause of the lymph nodes of patients, we must carefully ask sexual history and blood transfusion, blood donation history. (Zhang Zhifeng, Liu Yu, Zhang will become)
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