女孩,7岁,4年前发现左上腹有一肿块,并逐渐肿大,近2年又併有鼻衂,每次出血几毫升或几十毫升,偶有血便。近来逐漸消瘦,无家族史。体格检查:发育营养均差,面色苍白,神智清楚。全身皮肤未见出血点,浅表淋巴不肿大。心肺无异常。脾肿大:甲乙线为15.5厘米,丙丁线22厘米,中等硬度,表面光滑无压痛。肝大6厘米。实验室检查:红细胞250万,血红蛋白6克。白细胞2,400,中性24%, Girl, 7 years old, 4 years ago, found a lump on the left upper abdomen, and gradually enlarged, and nearly 2 years and epistaxis, each bleeding a few milliliters or tens of milliliters, occasional bloody stools. Recently wasting, no family history. Physical examination: Development and nutrition are poor, pale, clear mind. No bleeding of systemic skin, superficial lymph nodes are not swollen. No abnormal heart and lung. Splenomegaly: A line B is 15.5 cm, C Ding line 22 cm, medium hardness, smooth surface without tenderness. Liver 6 cm. Laboratory tests: 2.5 million red blood cells, hemoglobin 6 grams. 2,400 leukocytes, 24% neutral,