"骨髓-肝脏-脏类型的扩散性大B细胞淋巴瘤"呈现出寒冷的自身免疫血液溶解性贫血:一个病例报告
Ahalyaa Sivashangar1, Vinura Jithmal Meegoda1, Bhawani Yasassri Alvitigala2
1Department of Pathology, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka.
Journal of medical case reports
|December 21, 2024
概括
本病例报告详细介绍了一种罕见的骨髓-肝-类型的扩散性大B细胞淋巴瘤,呈现出冷自身免疫血清性贫血. 早期识别和积极治疗对于这种攻击性淋巴瘤亚型至关重要.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 主要骨髓扩散性大B细胞淋巴瘤 (DLBCL) 是罕见的.
- 骨髓-肝-脏 (BML-S) 类型的DLBCL是一种更罕见的亚型.
- BML-S DLBCL通常表现为发烧,细胞衰竭和血细胞淋巴细胞瘤.
研究的目的:
- 报告第一个记录的BML-S DLBCL病例,呈现出寒冷自身免疫血清性贫血症 (AIHA).
- 突出这一罕见疾病的独特临床表现和诊断挑战.
- 强调早期诊断和BML-S DLBCL积极管理的重要性.
主要方法:
- 一个39岁的女性的案例研究,呼吸短促,发烧和严重的肝炎.
- 诊断工作包括全血细胞计,周围血液涂抹,直接抗球蛋白测试,骨髓活检与免疫组织化学,和对比度增强的CT扫描.
- 免疫组织化学证实了CD20,BCL2和CD10阳性,Ki-67指数为24%.
主要成果:
- 患者出现了全细胞减小和血液溶解性贫血,通过阳性直接抗球蛋白检测证实了这一情况.
- 骨髓活检显示高细胞性与非典型的淋巴细胞与DLBCL一致.
- 脑电图扫描显示,肝大,没有显著的淋巴腺病变,支持BML-S型诊断.
- 这位患者被诊断出患有BML-S DLBCL和感冒AIHA.
结论:
- 这是首次报告的与寒冷AIHA相关的BML-S DLBCL病例.
- BML-S DLBCL的预后不好,需要及时诊断和治疗.
- 记录这种罕见的表现可以提高理解,并有助于管理不常见的血液恶性瘤.
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