[与血细胞分裂和多克隆性淋巴瘤出现的血性淋巴瘤]
Keiichi Uraisami1, Masuho Saburi1, Katsuya Kawano2
1Department of Hematology, Oita Prefectural Hospital.
概括
一个罕见的血性淋巴瘤病例在一个72岁的妇女成功治疗. 患者通过剂量调整的EPOCH化疗获得了完整的代谢反应.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
背景情况:
- 血性淋巴瘤是一种积极的非霍奇金淋巴瘤,通常与爱斯坦-巴尔病毒有关.
- 它主要影响免疫受损的个体,特别是那些患有晚期艾滋病毒感染的人.
研究的目的:
- 报告一个罕见的等离子体淋巴瘤病例,在一个免疫能力较强的老年妇女中呈现出泛性淋巴腺病变和多克隆性高血糖球蛋白血症.
- 突出诊断挑战和剂量调整-EPOCH化疗在实现缓解方面的有效性.
主要方法:
- 临床表现和实验室发现,包括人类免疫缺陷病毒 (HIV) 测试.
- 淋巴结活检的组织病理学检查与免疫组织化学染色 (CD19, λ,CD20,CD56,MIB-1指数).
- 埃普斯坦-巴尔病毒编码的RNA (EBV-EBER) 在位杂交.
- 18F-氧葡萄糖正子发射断层扫描 (FDG-PET) 用于分期和反应评估.
- 用剂量调整的EPOCH (埃托普西德,普雷迪尼索隆,温克里斯,环胺,多克索鲁比辛) 化疗进行治疗.
主要成果:
- 这位患者出现了泛性淋巴腺病变,血细胞症和多克隆性高甲基球蛋白血症.
- 淋巴结组织学揭示了对CD19, λ和EBV-EBER阳性等离子体细胞的单调种群,MIB-1指数高 (80%),与PBL一致.
- FDG-PET显示了淋巴结,脏和骨中广泛的疾病参与.
- 经过六次剂量调整的EPOCH治疗后,获得了完整的代谢反应.
结论:
- 血性淋巴瘤可以不典型地与泛性淋巴腺病变和多克隆性高甘球蛋白血症一起出现,即使在免疫能力强的人身上也是如此.
- 准确的诊断需要组织病理学,免疫组织化学和分子研究 (EBV检测) 的结合.
- 剂量调整的EPOCH化疗是一种有效的治疗方式,可以在PBL中实现缓解.
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