Sun Han-ying, Zheng Miao, Liu Wen-li, Zhou Jian-feng, Deng Jin-niu, Huang Mei
Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong Science and Technology University, Wuhan 430030, China.
Zhonghua Nei Ke Za Zhi. 2005 Feb;44(2):89-91.
To observe the clinical value of splenectomy for pathologic diagnosis in fever of unknown origin with splenomegaly only.
The pathologic findings of 35 patients with fever of unknown origin and splenomegaly treated by splenectomy, admitted in to the department of hematology in our hospital since 1996 were studied retrospectively. For these patients, there were no other positive signs except splenomegaly and the routine tests could not help us make the etiological diagnoses.
In these 35 patients, there were 17 cases of non-Hodgkin's lymphoma (48.6%), 5 cases of Hodgkin's disease (14.2%), 2 cases of malignant histiocytosis (5.7%), 5 cases of connective tissue disease (14.2%), 2 cases of chronic congestive splenomegaly (5.7%), 1 case of hemophagocytic syndrome (2.9%), 1 case of remote spleen infarction (2.9%), 1 case of tuberculosis of spleen (2.9%) and 1 case of spleen angiosarcoma (2.9%).
When only splenomegaly is found in patients with fever of unknown origin, it is necessary to persuade the patients to accept diagnostic splenectomy for pathological as soon as possible, otherwise, the diagnosis and treatment may be delayed.
观察脾切除术对仅表现为脾肿大的不明原因发热进行病理诊断的临床价值。
回顾性研究1996年以来我院血液科收治的35例因不明原因发热伴脾肿大而行脾切除术患者的病理结果。这些患者除脾肿大外无其他阳性体征，常规检查无法明确病因诊断。
这35例患者中，非霍奇金淋巴瘤17例（48.6%），霍奇金病5例（14.2%），恶性组织细胞病2例（5.7%），结缔组织病5例（14.2%），慢性充血性脾肿大2例（5.7%），噬血细胞综合征1例（2.9%），陈旧性脾梗死1例（2.9%），脾结核1例（2.9%），脾血管肉瘤1例（2.9%）。
不明原因发热患者若仅发现脾肿大，应尽早说服患者接受诊断性脾切除术以明确病理，否则可能延误诊治。
