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Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
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[第506个病例:来源不明的发烧,PET-CT阴性和血液瘤]
1Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua nei ke za zhi
|May 8, 2024
概括
一名患有两年间歇性发烧和体重减轻病史的患者在经历了自发的脏破裂后被诊断出患有扩散性大B细胞淋巴瘤. 这一案例突出了罕见的淋巴瘤呈现.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 病理学 病理学 病理学
背景情况:
- 间歇性发烧和体重减轻可能是具有挑战性的诊断表现.
- 淋巴瘤可以出现非特异性症状,使早期诊断复杂化.
- 自发骨破裂是一种罕见但危及生命的血液性恶性瘤并发症.
研究的目的:
- 报告一种罕见的自发裂病例,作为扩散型大B细胞淋巴瘤的初始表现.
- 讨论这种不寻常的临床场景的诊断挑战和管理.
- 强调在患有不明原因发烧和细胞衰竭的患者中考虑血液恶性瘤的重要性.
主要方法:
- 一个48岁的男性患者的病例报告.
- 分析了临床表现,实验室检查,成像 (PET-CT) 和病理发现.
- 记录了对甲基prednisolone和随后的紧急脊髓切除术的治疗反应.
主要成果:
- 该患者出现了两年的间歇性发烧,体重减轻和乳酸脱酶升高,最初怀疑是淋巴瘤,但在初始检查时没有明显的异常.
- 尽管因疑似炎症状况而接受甲基普雷迪尼索隆治疗,但该患者患上了血小板缺血和自发的脏破裂,导致血和出血性休克.
- 脏的病理检查证实了扩散的大B细胞淋巴瘤.
结论:
- 扩散性大B细胞淋巴瘤可以不典型地出现自发的脏破裂,即使在初步调查中没有典型的淋巴瘤发现.
- 在怀疑或确诊的淋巴瘤患者中,迅速识别和管理骨破裂等并发症至关重要.
- 这一案例强调了淋巴瘤呈现的异质性以及彻底的病理评估的重要性.
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