Nature clinical practice. Gastroenterology & hepatology · 2005
Hematological malignancy manifesting as ascites.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Lazaridis Konstantinos N, Abraham Susan C, Kamath Patrick S
Аннотация
BACKGROUND: A 63-year-old Caucasian woman presented with intermittent, left-sided abdominal discomfort without other symptoms. Physical examination revealed massive splenomegaly and complete blood counts showed thrombocytopenia. Splenectomy was recommended but the patient declined. She was lost to follow-up twice but returned with tense ascites about 2 years after the initial presentation. Despite aggressive medical management, the ascites did not improve.
INVESTIGATIONS: Bone-marrow and liver biopsies, abdominal ultrasound, esophagogastroduodenoscopy, abdominal CT scan and peripheral blood smear.
DIAGNOSIS: Primary splenic lymphoma with hepatic infiltration causing portal hypertension and ascites.
MANAGEMENT: Paracentesis, dietary sodium restriction and diuretics, splenectomy, splenorenal shunt and chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone).
INVESTIGATIONS: Bone-marrow and liver biopsies, abdominal ultrasound, esophagogastroduodenoscopy, abdominal CT scan and peripheral blood smear.
DIAGNOSIS: Primary splenic lymphoma with hepatic infiltration causing portal hypertension and ascites.
MANAGEMENT: Paracentesis, dietary sodium restriction and diuretics, splenectomy, splenorenal shunt and chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone).