1病例资料详见本刊2006年第26卷第1期第65页。2临床讨论本例有如下特点:(1)中年男性,既往体健。(2)隐袭起病,病程4个月。自觉胸闷、乏力,偶有盗汗、双指关节疼痛,体重下降3kg。无发热、咯血。(3)颈部及锁骨上窝可触及肿大淋巴结。双下肺叩诊浊音,听诊呼吸音减弱。(4)影像学示纵 1 case details, see the magazine 2006 Vol 26 No. 1 page 65. 2 Clinical Discussion This example has the following characteristics: (1) middle-aged men, past physical health. (2) insidious onset, duration of 4 months. Conscious chest tightness, fatigue, occasional night sweats, two-finger joint pain, weight loss 3kg. No fever, hemoptysis. (3) The neck and supraclavicular fossa can reach the enlarged lymph nodes. Double lower lung percussion dullness, auscultatory breath sounds weakened. (4) imaging study longitudinal