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患者女,64岁,1989年4月4日入院。左上腹肿物伴隐痛半年,近一个月腹痛加重,且食欲不振,体重减轻。体检:浅表淋巴结不大。左上腹肋缘下可扪及一肿块,中等硬,无明显压痛,活动差。胸透示左侧膈肌升高。B 超示脾脏肿大,有占位病变。化验:血红蛋白130g/L,白细胞6.9×10~9,中性69%,淋巴31%,血小板140×10~9/L。肝功能正常。在全麻下剖腹探查,见脾脏明显肿大约24×12×10cm,上极隆起肿
Female patient, 64 years old, admitted to hospital on April 4, 1989. Left upper quadrant tumor with pain for six months, abdominal pain increased nearly a month, and loss of appetite, weight loss. Physical examination: superficial lymph nodes are not. Left upper abdomen can be palpable under the costal edge of a lump, medium hard, no significant tenderness, poor activity. Thoracic showed left diaphragm elevation. B ultrasound showed splenomegaly, there are lesions. Laboratory tests: hemoglobin 130g / L, leukocytes 6.9 × 10 ~ 9, 69% neutral, lymphatic 31%, platelet 140 × 10 ~ 9 / L. Liver function is normal. Under general anesthesia exploratory laparotomy, see the spleen significantly swollen about 24 × 12 × 10cm, the most prominent swollen