肝脾肿大是临床常见的体症,多从肝硬化,血液病,疟疾后,及血吸虫病诸方面考虑。而原发于脾的淋巴瘤较少见,易造成误会,我们遇到1例,报告如下。患者,男,59岁,左上腹隐痛、饱胀4个月,曾在当地医院作A超,肾静脉造影等检查诊为“脾肿大”。于1986年5月12日以脾大待查转入我院。体检:轻度贫血,浅表淋巴结不肿大,心肺无异常,肝大肋下2cm,质中,脾大Ⅱ级,腹壁静脉不怒张,腹水症(-)。心电图、胸片、AFP、AKP均(-),两次骨髓检查结果为增生性贫血,肝扫描(-),两次B超结果为早期肝硬化,巨脾症。食道吞钡(-),肝功能、蛋白电泳(-),纤维结肠镜检(-)。既往有胃溃疡切除,右疝修补手术史, Hepatosplenomegaly is a common clinical disease, mostly from cirrhosis, blood diseases, malaria, and schistosomiasis aspects of consideration. The primary spleen lymphoma is rare, easy to cause misunderstanding, we encountered a case, the report is as follows. Patients, male, 59 years old, left upper quadrant pain, fullness for 4 months, had a local hospital for A ultrasound, renal vein angiography and other inspection diagnosis of “splenomegaly.” May 12, 1986 to spleen admitted to our hospital pending investigation. Physical examination: mild anemia, superficial lymph nodes are not enlarged, no abnormal heart and lungs, liver mass 2cm, mass, splenomegaly grade Ⅱ, abdominal vein without rage, ascites (-). Electrocardiogram, chest radiograph, AFP, AKP were (-), two bone marrow examination results for hyperplastic anemia, liver scan (-), twice the results of B-for early cirrhosis, splenomegaly. Esophageal barium (-), liver function, protein electrophoresis (-), colonoscopy (-). Previous gastric ulcer resection, right hernia repair surgery history,