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Linfoma de Células del Manto con Derrame Pleural Masivo Persistente que Requiere Ventilación Mecánica Invasiva y
Taichiro Tokura1,2, Youhei Imai1, Satoshi Sakai1
1Department of Hematology, Tokyo Metropolitan Tama-Hokubu Medical Center, 1-7-1 Aoba-cho, Higashimurayama-shi, Tokyo 189-0002, Japan.
Reports (MDPI)
|February 20, 2026
Resumen
El linfoma de células del manto (LCM) rara vez causa derrames pleurales masivos que requieren ventilación mecánica. La inmunoterapia rápida resolvió los derrames, permitiendo la extubación y la remisión en este caso raro.
Área de la Ciencia:
- Hematología; Oncología; Neumología
Sus antecedentes:
- El linfoma de células del manto (LCM) afecta comúnmente la médula ósea y el tracto gastrointestinal, siendo raros los derrames pleurales. Los casos de LCM que requieren ventilación mecánica invasiva y drenaje torácico son excepcionalmente infrecuentes. Este informe detalla un caso raro de LCM que se presenta con derrames pleurales masivos y persistentes.
Objetivo del estudio:
- Presentar un caso raro de linfoma de células del manto (LCM) con derrames pleurales masivos. Destacar los desafíos diagnósticos y terapéuticos asociados con esta presentación. Enfatizar la importancia del tratamiento rápido en el manejo de complicaciones potencialmente mortales del LCM.
Principales métodos:
- Paciente femenina de 71 años con disnea y derrames pleurales bilaterales. El estudio diagnóstico incluyó citometría de flujo del líquido pleural, examen de médula ósea y biopsia de ganglio linfático cervical. El tratamiento implicó inmunoterapia (R-CHOP) iniciada durante la ventilación mecánica, junto con drenaje torácico continuo bilateral.
Principales resultados:
- La paciente requirió ventilación mecánica invasiva y drenaje torácico bilateral debido a insuficiencia respiratoria aguda por derrames pleurales. La inmunoterapia condujo a la resolución gradual de los derrames pleurales, permitiendo la extubación y la retirada del tubo de tórax. Se logró la remisión completa, con regresión de la linfadenopatía y resolución de la infiltración de la médula ósea.
Conclusiones:
- El linfoma de células del manto (LCM) con derrames pleurales masivos que requieren ventilación mecánica y drenaje torácico es un escenario clínico raro. El diagnóstico temprano y la inmunoterapia agresiva son cruciales para manejar tales presentaciones graves. Reconocer el LCM como una causa potencial de derrames pleurales masivos es vital para una intervención oportuna y mejores resultados para el paciente.
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