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原因不明的髓样化生又称骨髓纤维化。约半数病人以巨脾的压迫、贫血或出血为主诉。病人可能因胃肠道出血被建议做脾切除手术。作者以1例脾静脉和门静脉血栓形成,经保守治疗的患者为例,阐明术前检查用以估价内脏血液动力学及肝脏结构改变的重要性。患者:60岁、女性,进行性腹胀两年。血压110/70,肝肋下3cm,硬无触痛,脾入腹腔15cm,Hb10.5g,白细胞9.9×10~9/l,分叶61%,嗜酸1%,嗜碱1%,杆状11%,晚幼粒1%,中幼粒6%,原始粒2%,淋巴10%,异型淋巴1%,单核6%,血小板382×10~9/l,红细胞大小不等,有异型红细胞及泪滴样红细胞.网织红细胞1.9％,超声示均质性脾肿大。骨髓抽吸及环钻活检示造血组织增生不良伴网硬蛋白
Unidentified myeloid metaplasia, also known as bone marrow fibrosis. About half of patients with splenomegaly compression, anemia or bleeding as the main complaint. Patients may be recommended for splenectomy due to gastrointestinal bleeding. The authors of a case of splenic vein and portal vein thrombosis, conservative treatment of patients as an example to clarify the importance of preoperative examination to assess visceral hemodynamics and liver structural changes. Patient: 60 years old, female, progressive bloating for two years. Blood pressure 110/70, liver ribs 3cm, hard no tenderness, spleen into the abdominal cavity 15cm, Hb10.5g, white blood cells 9.9 × 10 ~ 9 / l, leaf 61%, 1% acidophilic, basophilic 1% 11%, late promyelocytic 1%, juvenile 6%, primal 2%, lymphatic 10%, atypical lymphoid 1%, mononuclear 6%, platelet 382 × 10 ~ 9 / l, red blood cell size range, Red blood cells and tear-like red blood cells. Reticulocyte 1.9%, ultrasound showed homogeneous splenomegaly. Bone marrow aspiration and pericardial biopsy showed hematopoietic dysplasia with mesodermal protein