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患者女性,40岁。1994年6月9日因反复左上腹胀痛不适6月余入院。疼痛以深吸气及左侧卧位时明显。无放射痛,无发热,无黄疸。体检:腹平软,未触及明显肿块,左上腹部深压痛,脾区叩击痛。B超提示脾脏多发性囊性占位病变。CT提示脾脏占位性病变。实验室检查:Hb102g/L.WBC9.2×10~9/L.N0.76,L0.24。于1994年6月21日行剖腹探查术。术中见脾脏肿大,边缘不整,近圆形,质硬,表面高低不平,散在白色斑块,脾脏与侧腹壁、膈肌广泛粘连。完整切除脾脏,并取周围淋巴结做活检。标本肉眼所见:脾脏肿大(约为正常的1.5倍),肿块内为实质枯肉芽样组织,有多囊性血肿。病理诊断:脾脏原发性
Female patient, 40 years old. On June 9, 1994, she suffered discomfort and pain for more than six months after admission. Pain is noticeable with deep breathing and lying in the left lateral position. No radiating pain, no fever, no jaundice. Physical examination: The abdomen was soft, without obvious masses, deep tenderness in the left upper abdomen, and percussive pain in the spleen area. B ultrasound prompted splenic multiple cystic lesions. CT suggests splenic space-occupying lesions. Laboratory examination: Hb 102g/L.WBC 9.2×10~9/L.N0.76, L0.24. The laparotomy was performed on June 21, 1994. During the operation, the splenomegaly was seen with irregular edges, near-circular shape, hard texture, uneven surface, scattered white patches, and extensive adherence of the spleen to the lateral abdominal wall and diaphragm. The spleen was completely resected and peripheral lymph nodes were taken for biopsy. Specimens were seen with the naked eye: the spleen was swollen (about 1.5 times normal), and the mass was parenchymatous, with a polycystic hematoma. Pathological diagnosis: Primary spleen