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患者男,63岁。因腹胀、纳差、皮下出血点2年余,近来症状加重伴发热于1998年1月26日入院。查体:体温38.2℃,消瘦,精神差,咽充血;耳后、颌下、锁骨上、双侧腋窝和腹股沟均可触及黄豆至蚕豆大小淋巴结,表面光滑,质硬,活动可;全身皮肤散在针尖大小鲜红色出血点。心、肺未发现异常。腹膨隆,肝脏于右肋下 2.0cm可触及,剑突下:2.0cm,质软,表面光滑,无压痛。脾脏肿大,测得A线 11.0cm,B线14.0cm,C线-5.0cm,质硬,表面光滑,无压痛。血象:WBC 12.3×10~9/L,N0.38,L 0.62;PC 72×10~9/L。B超提示:肝脏剑突下3.0cm,右肋下1.0cm,右叶厚 6.8cm;脾脏重度肿大,测量值同上。骨髓
Male patient, 63 years old. Due to abdominal distension, anorexia, subcutaneous bleeding point more than 2 years, the recent increase in symptoms with fever in January 26, 1998 admission. Examination: body temperature 38.2 ℃, weight loss, poor spirit, pharyngeal congestion; behind the ear, submandibular, supraclavicular, bilateral axilla and groin can reach the beans to the size of broad bean lymph nodes, the surface is smooth, hard, activity can be; Pinpoint fresh red bleeding point. Heart, lungs found no abnormalities. Abdominal bulge, the liver in the right rib 2.0cm palpable, xiphoid: 2.0cm, soft, smooth surface, no tenderness. Splenomegaly, measured A line 11.0cm, B line 14.0cm, C line -5.0cm, hard, smooth surface, no tenderness. Blood: WBC 12.3 × 10 ~ 9 / L, N0.38, L 0.62; PC 72 × 10 ~ 9 / L. B-Tip: liver xiphoid 3.0cm, right rib 1.0cm, right lobe 6.8cm thick; severe splenomegaly measured value ibid. marrow