白血病髓外肝脾肾浸润CT表现及临床意义

目的:提高对白血病髓外肝肾浸润的影像认识。方法:对6例临床确诊急性淋巴细胞性白血病(ALL)患者的腹部CT资料进行分析;2例平扫,4例平扫及增强扫描。结果:受累浸润的脏器形态有不同程度的增大;肝脏浸润4例,3例呈弥漫性、1例结节性;脾脏浸润2例均表现为弥漫性,肾脏浸润3例,均为双侧,2例弥漫性、1例多发结节性。2例合并累及。增强扫描轻度强化或不强化。结论:白血病累及肝脾肾CT以弥漫性、多发结节性浸润为主要表现,影像学检查对了解白血病肝脾肾的浸润程度与范围、有无并发症和观察治疗反应有重要意义。

浅谈从肝脾肾论治高脂血症

高脂血症发病的根本因素是肝脾肾三脏功能失调。因膏脂的生成与转化无不与肝之疏泄、气机调畅、脾之运化、肾阳的温煦及肾阴的滋养功能有关，故肝脾肾脏腑功能失调是高脂血症发病的重要病机。肝脾肾脏是影响血脂正常代谢的关键。治疗时应综观全身脏腑间的相互作用，注意先、后天并补，在固本的同时不忘治标，配合应用化痰、祛瘀等法，能有效地降低血脂。从肝脾肾论治高脂血症具有很重要的临床意义。

Pedunculated hepatocellular carcinoma and splenic metastasis

Only a few cases of pedunculated hepatocellular carcinoma (P-HCC) have been reported in the literature. The common sites of extrahepatic metastases in patients with HCC are the lungs, regional lymph nodes, kidney, bone marrow and adrenals. Metastasis to spleen is mostly via hematogenous metastasis, direct metastasis to spleen was very rare. We report a case of P-HCC presenting as a left upper abdominal lesions which involved the spleen that was actually a P-HCC with splenic metastasis. This case is unique as P-HCC directly involved the spleen which is not via hematogenous metastasis.