以睾丸肿大为首发症状的白血病4例分析并文献复习

目的：探讨睾丸肿大为首发症状的白血病的诊断和治疗原则。方法：回顾性分析了4例首诊入住泌尿外科．以睾丸肿大为首发症状的白血病(TL)患者的临床资料。结果：1例睾丸肿大为慢性粒细胞白血病所致；2例TL为急性淋巴细胞白血病；1例是急性非淋巴细胞白血病。4例均有血象的异常升高，伴有不同程度的脾肿大和胸骨下段压痛各2例。4例均行病变睾丸的切除、健侧睾丸的预防性放疗并行全身化疗。平均生存期4.5a。结论：以睾丸肿大为首发症状的白血病误诊率高。对TL应采用综合方法治疗，化疗和局部的放疗是主要的治疗措施，病变睾丸的切除是否利于提高患者的生存期有待于进一步研究。

Analysis of 4 Cases of Leukemia with Testicular Tumescence as the First Symptomand Literature Review

Objective:To investigate the diagnosis and treatment of leukemia with testicle tumescence as the first symptom.Methods:Clinical data of 4 cases of leukemia with testicular leukemia (TL) as first symptom were collected and analyzed retrospectively.Results:Among the four cases, there was 1 chronic granulocytic leukemia(CGL) ,2 acute lymphoblastic leukemia and 1 myeloid leukemia.All 4 patients had abormal blood routine test,in which 2 patients were accompanied by splenic tumescence and breastbone tenderness. Orchiectomy was performed in the injured testis followed by preventive irradiation and chemotherapy in the uninjured testis.Mean subsistence time was 4.5 years.Conclusions:Leukemia with testicular tumescence as the first symptom was easily misdiagnosed. Comprehensive treamentincluing chemotherapy and local irradiation was extensively adopted.It remained to discuss whether orchiectomy could improvethe survival rate.