At admission, she presented with hypoesthesia of superficial sensibility from bilateral
costal margins to knees, positive bilateral Hoffman sign, and Babinski sign.
Physical examination revealed an enlarged spleen with the tip of spleen palpated about 3 cm below the
costal margins.
The abdomen was not distended, the palpation revealed no tenderness, the liver and spleen edges were parallel to
costal margins.
Physical examination revealed a firm mass about 2 cm below the
costal margins about 5 x 3 cm, globular and moving with respiration.
No exanthema was noted, the liver was palpable 1 cm under the
costal margins, and the spleen was not enlarged.
DIAGNOSIS: Pinophylus is distinguished from other conifer inhabiting genera of Phylini by the distinctive sexual dimorphism, with the
costal margins of the hemelytra elongate and parallel-sided in the male and shorter and subovoid in the female; the brownish black dorsum with inconspicuous dark simple setae; the pretarsus with the base of the claw expanded and the pulvillus small; and the endosoma composed of two straps with a subapical secondary gonopore.
DE refers to thinning of all or part of the hemidiaphragm while maintaining continuity with the
costal margins, resulting in elevation and cranial displacement of intra-abdominal viscera on the affected side.
The liver and spleen were palpable 10 cm and 11 cm below the
costal margins, respectively.
The entire physical examination of this active thriving infant is normal, except that he has a prominent liver and spleen by palpation, each approximately 6-7 cm below the
costal margins.
Distinguished from Schuhistes leckkersingia by the presence of a golden partial to complete fascia on the anterior half of the hemelytra, the straighter
costal margins of the hemelytra in the males, the smaller size and C-shape of the vesica, and the narrow more-or-less parallel-sided apex of the phallotheca.
Her liver and spleen were palpable 4 cm and 5 cm below their respective
costal margins.
5-1 cm), hepatomegaly palpable 3 cm and massive splenomegaly palpable 10 cm below respective
costal margins.
