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【简答题】
女性,26岁。颈前增粗3个月。患者3个月前无意中发现颈前增粗,无疼痛和发热,无心慌、多汗、怕热。发病以来饮食正常,大、小便及睡眠均正常,体重无下降。既往体健,妊娠7个月,无肿瘤家族史。查体:T36.4℃,P80次/分,R20次/分,BP120/70mmHg。皮肤、巩膜无,双侧颈部及锁骨上淋巴结未触及肿大。口唇无发绀,气管居中,甲状腺呈对称性Ⅱ度肿大,表面光滑,质软,听诊无血管杂音。双肺未闻及干、湿啰音,心界不大,心率80次/分,律齐。腹7个月妊娠大小,无压痛,肝脾肋下未触及,移动性浊音(-),肠鸣音正常。脊柱四肢无异常。产科检查胎儿正常。实验室检查:血常规:Hb110g/L,WBC6.0×10 9 /L,N0.68,Plt260×10 9 /L,粪常规(-),尿常规(-)。要求:根据以上病历摘要,请写出初步诊断及诊断依据(两个以上诊断,应分别写出各自诊断依据,未分别列出扣分),鉴别诊断,迸一步检查与治疗原则。
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