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the message below is both in Chinese and English中国医学健康网Case Report: FibroangiolipomaThe date to be hospitalized: 2000-2-3A 34-year old male peasant complained about swelling and low temperature, numbness in his left upper limb for about 23 days.It is on 10th, January 2000, the patient felt pain and swelling in his left upper limb after lifting a bucket of water, and the condition aggravated as times went by. The anti-inflammation, hemostatic therapy did not make it, and the patient came to Xijing Hospital for further treatment. In 1987, and 1991, the patient found the swelling in his left limb after injury, but it was cured with anti-inflammation and hemostatic therapy. No history of bleeding. The left limb was somewhat bulky than the right one when he was an infant. Physical Examination: Multiple spots of light brown pigmentation on the skin (cafe au lait spots) of the trunk and limbs ranging in size from a few millimeters to several centimeters, subcutaneous soft tissue tumors (atheroma-like tumors) ranging is size about 2*3*1cm. From the left shoulder joint to the hand, the skin is doted with large area of cafe au lait spots, the limb swelled severely that tension vesicles formed, and some of the vesicles broken down. The skin temperature was high in the arm and near elbow joint, but low in hand. No blood circulation, no movement, no sensation in left hand. The beat of humeral and radial artery could not be palpated.Laboratory Test: Routine Blood Test: White Blood Cell: 24.9*109/L, Hb: 56g/L, Platelet: 520*109/L, BUN: 5.1 mmol/L, Cr:67mmol/L, PT(prothrombin time): 13.28s.Liver Function: ItemValueNormal valueALT287 Iu/L0~40AST308 Iu/L0~40TP55g/L60~87TBIL19.3mmol/L6.0~19.2A/G1.011.5~2.5Blood sugar7.3 mmol/L3.9~5.8BUN4.8 mmol/L2.8~7.2Cr63 mmol/L53~125Electrolytes: K, Na, Cl, Ca, CO2-CP are in normal range of value. Urine: erythrocyte 150/ml +++, UBG: 68 mmol/L +, Stool: normalClinical Diagnosis: NeurofibromatosisTreatment: Disarticulation of shoulderPathologic Diagnosis: FibroangiolipomaBlood transfusion before operation, in operation, and after operation: concentrated erythrocyte: 18.0u, Serum 1710ml, Cold sendimentated serum: 6.0uDifferential Diagnosis: hemophilia or other disease due to the deficiency of coagulation factors. The coagulation factor VIII can not be tested due to the winter vocation and the Spring Festival holiday in China(the University is in holiday)We exclude the possible bleeding condition by transfuse concentrated erythrocyte, cold sendimentated serum and fresh serum. The message below is in Symplified Chinese入院日期: 2000-2-3患者, 男性, 34岁, 农民, 左上肢外伤后肿胀, 肢端发凉23天入院.患者于2000年1月10日提携重物(一桶水)后, 左上肢出现肿胀, 丙呈进行性加重, 于当地医院行抗炎, 止血治疗无好转, 随来我院就诊. 1987年, 1991年曾因外伤后出现类似病情, 行补液, 止血治疗后好转. 否认有出血倾向史, 曾有便中带血史, 诊断为"痔疮", 对症治疗后好转. 左上肢自幼较右上肢为粗, 其父(已故)身体上有多处棕色斑及"粉瘤"状包块.查体: 一般情况尚可.全身斑点状褐色色素斑及散发包块, 包块大小约: 2*3*1厘米大小, 质软, 无压痛, 界清, 肤色正常, 表面皮肤可随其而移动, 左上肢自肩部以远斑片状褐色色素沉着, 并严重肿胀, 皮肤表面大量张力性水泡形成, 部分水泡破溃, 并有血性渗出物渗出, 上臂及肘部皮温高, 手部肤色黑紫, 皮 [1] [2] 下一页 |
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