患者女性,59岁。左下腹疼痛伴腹胀不适4天以巨脾伴脾内出血住院。查体:腹部膨隆,脾肋下20 cm,右侧达腋前线,占据腹腔大半部,质硬,活动度一般,左下腹轻压痛。腹部B超示左上腹实性包块,少量腹水。上腹部CT示巨大脾,实质密度不均,可见出血、坏死及囊性变,脾周少量积液,腹膜后未见肿大淋巴结。切除脾送病理检查。 Patient female, 59 years old. Left lower quadrant pain with bloating discomfort 4 days with splenomegaly with bleeding in the hospital. Physical examination: bulging abdomen, spleen ribs 20 cm, up to the anterior axillary line, occupying most of the abdominal cavity, hard, normal mobility, left lower quadrant soft tenderness. Abdominal B-ultrasound showed the left upper abdomen solid mass, a small amount of ascites. Upper abdominal CT showed huge spleen, uneven density, visible bleeding, necrosis and cystic degeneration, a small amount of splenic effusion, no retroperitoneal lymph nodes. Removal of spleen to send pathological examination.