恶性淋巴瘤国内并非少见,但脾源性恶性淋巴瘤并非多见,笔者遇见1例且合併右下肢深静脉血栓形成,现报告如下。 病例:邢某,男,77岁。因右上肢外伤后不适10余年,疼痛月余。于2001年2月8日入院。始于10年前,不慎被硬物击中左上腹,当时疼痛难忍,未经特殊处理,自行缓解。嗣后仅间断性左上腹隐隐作痛;于1月前查体发现脾内占位性包块,遂觉疼痛,不放射无腹泻。无呕吐。 查体:T36.7℃ HR62/分 R18/分 BP140/80mmHg。皮肤粘膜无异常,浅淋巴结不肿大,五官无异常。两肺呼吸音清,心界不扩大,心律齐,心音正常。腹膨隆,未见肠型及蠕动波。肺叩诊异大,液中线6～10肋余无异常。 B超:脾明显增大,形态正常,脾内可见8.2cm×6.4cm,相对强回声,边界清,回声均匀与左肾界限清晰肿物。 彩超示脾实质性占位,右下肢深静脉血检形成。 CT示脾多发性占位,恶性可能性大。 病理诊断:脾原发性(脾原性)恶性淋巴瘤。 於2月14日行脾脏切除术及其它对症处理,术后至今 Malignant lymphoma is not uncommon in China, but splenic lymphoma is not common, I met one case and combined with deep vein thrombosis of the right lower extremity. The report is as follows. Case: Xing Mou, male, 77 years old. After more than 10 years of discomfort due to traumatic injuries to the right upper limb, more than a month of pain. Admitted to hospital on February 8, 2001. Began to hit the left upper abdomen by hard objects ten years ago. At that time, the pain was unbearable and he was relieved without special treatment. After the ankle, only the intermittent left upper quadrant was dull; at the end of the previous month, the examination revealed a mass in the spleen, pain in the spleen, and no radiation or diarrhea. No vomiting. Physical examination: T36.7°C HR62/min R18/min BP140/80mmHg. There were no abnormalities in the skin and mucous membranes, and the superficial lymph nodes were not swollen. There were no abnormalities in facial features. The breath sounds clear in both lungs, the heart does not expand, heart rate is equal, and heart sounds are normal. Abdominal bulging, no intestinal and peristaltic wave. The lung palpation is different, and there is no abnormality in the fluid center line 6-10 ribs. B-ultrasound: The spleen was obviously enlarged, and the morphology was normal. Within the spleen, there was 8.2cm×6.4cm. The echo was relatively strong, the boundary was clear, and the echo was even with the left kidney. Ultrasound showed a substantial occupying of the spleen, and a blood test of the deep vein of the right lower limb was formed. CT showed spleen multiple occupancy, malignant possibility. Pathological diagnosis: splenic primary (splenic) malignant lymphoma. Performed splenectomy and other symptomatic treatment on February 14th.