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患者男,60岁。以左阴囊无痛性增大2年入院。2年前觉左阴囊部沉重,渐大,但不疼,近1年来肿大明显,影响劳动和走路。查体:一般状况良好,全身浅表淋巴结无肿大。左侧阴囊40×38×35cm 大,质坚硬、表面光滑,无触痛,但未触到睾丸。透光试验阳性。右侧睾丸正常。穿刺液细胞学检查有较多红细胞、淋巴细胞,另可见数个体积稍大的细胞,染色质稍增加;还见少量间皮细胞。临床诊断:左侧巨大睾丸鞘膜积液。术中见鞘膜内有淡黄色透明液体约1700ml,睾丸明显肿大,质硬,予以切除。病理检查:睾丸为15×12×12cm 大,有完整的包膜,切面呈实性鱼肉状。病理诊断:睾丸精原细胞瘤。
Male patient, 60 years old. To left scrotum painless increase 2 years admission. 2 years ago, left scrotum heavy, getting bigger, but not hurt, swelling significantly over the past year, affecting labor and walking. Physical examination: the general condition is good, systemic superficial lymph nodes without swelling. Left scrotum 40 × 38 × 35cm large, hard quality, smooth surface, no tenderness, but did not touch the testicles. Light transmission test positive. Right testes normal. Puncture fluid cytology more red blood cells, lymphocytes, and the other can see a few bulky cells, slightly increased chromatin; also see a small amount of mesothelial cells. Clinical diagnosis: left huge testicular hydrocele. Visceral see intraoperative pale yellow transparent liquid about 1700ml, testicular obvious swelling, hard, to be removed. Pathological examination: Testicular 15 × 12 × 12cm large, complete capsule, section was a real fish-like. Pathological diagnosis: testicular seminoma.