Saito Satomi, Kodama Kazuhisa, Kogiso Tomomi, Yamanashi Yuki, Taniai Makiko, Ariizumi Shunichi, Yamamoto Masakazu, Tokushige Katsutoshi
Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan.
Institute of Gastroenterology, Department of Surgery, Tokyo Women's Medical University, Japan.
Intern Med. 2020 Mar 1;59(5):641-648. doi: 10.2169/internalmedicine.3646-19. Epub 2019 Oct 31.
We examined a 22-year-old woman who was admitted to our hospital with abdominal distention. At 19 years of age, the patient presented with hepatosplenomegaly. She was examined several times in another hospital; however, the cause was unidentified. Our evaluation showed severe pancytopenia and a spleen 13×24 cm in size. The serum levels of angiotensin-converting enzyme and lysozyme were elevated. She was diagnosed with liver sarcoidosis based on non-caseating epithelioid granuloma in liver biopsy tissue. To improve the symptoms, splenectomy was performed, and her pancytopenia and symptoms improved. Sarcoidosis should be considered in cases of massive splenomegaly.
我们检查了一名因腹胀入院的22岁女性。患者19岁时出现肝脾肿大。她在另一家医院接受了多次检查，但病因不明。我们的评估显示严重全血细胞减少，脾脏大小为13×24厘米。血清血管紧张素转换酶和溶菌酶水平升高。根据肝活检组织中的非干酪样上皮样肉芽肿，她被诊断为肝结节病。为改善症状，进行了脾切除术，她的全血细胞减少和症状得到改善。对于出现巨大脾肿大的病例，应考虑结节病。
