由Epstein-Barr病毒阳性原发性扩散性大B细胞淋巴瘤引起的肠道穿孔,患者患有人类免疫缺陷病毒
Qiuli Liu1, Qun Bao2, Bin Zhao1
1Anesthesiology and SICU, Xinhua Hospital ffiliated to Shanghai jiaotong University School of Medicine, China.
Revista espanola de enfermedades digestivas
|December 14, 2023
概括
一名患有腹痛和便秘的患者被诊断出IV期扩散型大B细胞淋巴瘤 (DLBCL). 该患者后来被发现是艾滋病毒阳性,在初始治疗后出现了败血症和肠道穿孔.
科学领域:
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
- 胃肠病学 胃肠病学
背景情况:
- 一名48岁的男性出现了两周的右下腹疼痛和便秘病史.
- 最初的CT扫描表明恶性瘤阻碍了上升结肠.
研究的目的:
- 报告一个复杂的IV期扩散型大B细胞淋巴瘤 (DLBCL) 病例,同时感染艾滋病毒.
- 突出诊断挑战和免疫功能低下患者的治疗并发症.
主要方法:
- 腹部CT,直肠镜,全身对比增强FDG-PET/CT.
- 结肠镜检查包括活检,组织病理学和免疫组织化学检查 (CD20,CD19,CD10,BCL-6,Ki-67).
- 在EBV-DNA PCR和艾滋病毒检测.
主要成果:
- 在FDG-PET/CT中,广泛的淋巴瘤 (上升结肠,腹膜,骨髓,淋巴结) 被发现.
- 病理学证实DLBCL具有高扩散指数 (Ki-67 90%) 和特定标志物.
- 患者被诊断患有第四期DLBCL,EBV-DNA阳性,随后被发现是HIV阳性.
- 在R-CHOP治疗后,并发症包括肠道穿孔和败血症.
结论:
- 同时的艾滋病毒感染使DLBCL的管理变得复杂.
- 早期诊断和积极管理至关重要,但可能会出现并发症.
- 这一案例强调了免疫功能低下,腹部症状的患者进行全面检查的重要性.
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