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患者,男,60岁。因低热、腹胀、纳差伴间歇黑便一月于1991年8月29日入院。查体:消瘦,腹部隆起,中上腹触及多个质硬光滑肿块,最大10cm×10cm,固定、无压痛,腹水征(+),肝脾未及。大便隐血(-),腹部B超:肝左叶59mm×81mm,右叶93mm×95mm,脾脏35mm×91mm,均未见占位病变,肝、脾门及腹主动脉周围大小不等低回声结节,直径14mm～30mm融合成片,肝前腹水28mm。胃肠钡餐为胃底部占位性肿块。胃镜示胃底部有7cm×7cm溃疡型巨大肿块、灰白色、质硬、易出血,病检恶性淋巴肉瘤、网状细胞型。腹水镜检及腹块穿刺病理均为恶性淋巴网状肉瘤。行COMP方案化疗一疗程后症状消失,腹块缩小;6疗程后复查腹部未及肿块,B超:腹腔未见肿块,腹水(-);胃镜(-);大便隐血(-)。
Patient, male, 60 years old. He was admitted to hospital on August 29, 1991 due to low fever, bloating, and poor appetite. Physical examination: weight loss, abdomen bulge, mid-upper abdominal mass touched a number of hard and smooth mass, maximum 10cm × 10cm, fixed, no tenderness, ascites sign (+), liver and spleen is not. Faecal occult blood (-), Abdominal B-ultrasound: Liver left lobe 59mm × 81mm, right lobe 93mm × 95mm, spleen 35mm × 91mm, no lesions were seen, liver, spleen and abdominal aorta around the size of the hypoechoic junction Festival, diameter 14mm ~ 30mm fusion into pieces, liver anterior ascites 28mm. Gastrointestinal barium is a mass occupying the bottom of the stomach. The gastroscope showed a large ulcer of 7cm×7cm in the bottom of the stomach, grayish white, hard and easy bleeding, and malignant lymphosarcoma and reticulocyte type. Ascites microscopy and abdominal puncture pathology are malignant lymphorectal sarcomas. After one course of COMP regimen chemotherapy, the symptoms disappeared and the abdominal mass was reduced. After 6 cycles, the abdominal masses were not examined. B-mode ultrasound: no lumps in the abdominal cavity, ascites (-); gastroscope (-); fecal occult blood (-).