与高热血症相关的霍奇金淋巴瘤呈现为正常压力脑水:一个病例报告
Sean Lief1, Ali Z Ansari2, Samer Beauti1
1Department of Internal Medicine, William Carey University College of Osteopathic Medicine, Hattiesburg, USA.
Cureus
|November 14, 2024
概括
本案例研究详细介绍了一种罕见的高级霍奇金淋巴瘤呈现,该淋巴瘤发生在一名63岁的男性身上,患有高血症和模仿正常压力水脑的症状. 早期诊断和治疗对于管理这种复杂的恶性瘤至关重要.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 神经学 神经学
背景情况:
- 霍奇金淋巴瘤是一种淋巴系统恶性瘤.
- 很少,它呈现出高级特征,如脊髓干扰和高血症.
- 这个病例涉及一个患有类似正常压力头症的症状的患者.
研究的目的:
- 呈现一种罕见的晚期霍奇金淋巴瘤病例,具有非典型的神经症状和高血症.
- 强调诊断方面的挑战和综合性评估的重要性.
- 讨论治疗策略和预后.
主要方法:
- 一个63岁的男性的病例报告.
- 临床表现,实验室发现 (白细胞瘤,贫血,高血症,急性损伤) 和成像 (淋巴腺病,上腺质量,骨髓异常).
- 诊断通过中枢淋巴结活检证实;与偏生态综合征相关的高热血症.
主要成果:
- 患者出现了步行障碍,精神状态变化和尿失禁,这是正常压力头症的特征.
- 他被诊断出患有高级霍奇金淋巴瘤,并患有超血症作为副瘤的表现.
- 治疗包括高血症的管理和化疗 (阿德里亚米辛,白胺,温布拉斯,达卡巴).
结论:
- 在异常表现的患者中,包括神经症状和高血症,应考虑霍奇金淋巴瘤.
- 全面的诊断工作对于及时诊断和管理至关重要.
- 虽然高血症表明预后不好,但像布伦图西马布维多丁 (brentuximab vedotin) 这样的新疗法为脆弱患者提供了希望.
相关概念视频
Graves Disease II: Pathophysiology
59
Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor,...
59
Cushing Syndrome II: Pathophysiology
58
Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features...
58
Increased Intracranial Pressure l: Introduction
31
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component...
31
Increased Intracranial Pressure ll: Pathophysiology
43
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins...
43
Cerebral Edema ll: Pathophysiology
31
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this...
31
Cytotoxic Edema: Pathophysiology
31
Cytotoxic edema is a form of cerebral edema characterized by intracellular swelling of neurons, astrocytes, and other glial cells. It develops when the mechanisms responsible for maintaining ionic gradients across the cell membrane become impaired. Under normal physiological conditions, the sodium–potassium ATPase actively transports sodium ions out of the cell and potassium ions into the cell, preserving osmotic balance and enabling electrical signaling. This pump requires a continuous...
31


