脾脏切除在长期发热伴脾脏肿大中的诊断价值

目的 探讨发热待查在临床上公有脾肿大供组织学诊断中行脾切除术的价值。方法 回顾分析了我院血液科1996年来以发热待查收住院,除发热、脾肿大外无其它阳性体征,且辅助检查也为阴性的14例患者的临床资料,行脾切除术后取脾脏作病理学检查。结果 14例患者中,霍奇金淋巴瘤3例,非霍奇金淋巴瘤5例,结缔组织病3例,恶性组织细胞病2例,脾陈旧性梗死1例。随访15－54个月,3例结缔组织病完全缓解;1例脾陈旧性梗死痊愈;淋巴瘤3例完全缓解,1例部分缓解。结论 发热待查而临床上仅有脾肿大时,应动员患者尽早地作诊断性脾切除术并送病理学检查,以免延误诊断和治疗。

The value of splenectomy in fever of unknown origin

Objective To evaluate the significance of the splenectomy in fever of unknown origin (FUO) when only splenomegaly can be found for histologic diagnosis. Methods The pathologic findings of 14 patients with FUO by splenectomy, who had been admitted in the department of hematology of our hospital since 1996 were retrospectively studied. For these patients, there were no positive signs except splenomegaly, and the tests were normal. Results There were 3 cases of Hodgkin's disease, 5 cases of non Hodgkin's lymphoma, 3 cases of connective tissue disease, 2 cases of malignant histiocytosis and 1 case of remote spleen infarction. After a follow up of 15 to 54 months, all 3 cases of connective tissue disease had got remission completely, 1 case of remote spleen infarction had been cured. As to the 4 cases of lymphoma, 3 had got remission completely, while the other had got remission partly. Conclusion When only splenomegaly is found in patients with FUO, it is necessary to persuade the patients to accept diagnostic splenectomy for pathology as soon as possible, otherwise, the diagnosis and treatment may be delayed.