[血管内大型B细胞淋巴瘤呈现为亚急性渐进性骨髓病变]
Kiwamu Doi1, Yosuke Nonohara1, Soichiro Sakamoto1
1Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-Kofukai.
[Rinsho ketsueki] The Japanese journal of clinical hematology
|February 9, 2025
概括
血管内大B细胞淋巴瘤 (IVLBCL) 只能呈现为骨髓病,这是一个罕见的神经表现. 这一案例凸显了考虑IVLBCL的重要性,即使没有典型的B型症状.
科学领域:
- 在瘤学瘤学.
- 神经学 神经学
- 血液学 血液学 血液学
背景情况:
- 血管内大B细胞淋巴瘤 (IVLBCL) 通常表现出各种症状,包括宪法B症状,神经缺陷和皮肤病变.
- 由于可变的临床表现和潜在的非神经症状缺失,诊断可能具有挑战性.
研究的目的:
- 报告一个独特的IVLBCL病例,它只表现为骨髓病变.
- 强调IVLBCL的诊断考虑,当神经症状是主要或唯一的表现时.
主要方法:
- 一名64岁的男性呈现出进展性骨髓病变 (腿部软弱,膀/直肠功能障碍),没有最初的宪法症状.
- 最初的调查包括血液检测,脑液分析,皮肤和骨髓活检,对于淋巴增殖性疾病没有确定性.
- 在发烧,LDH/sIL-2R升高以及肺部卷入的PET/CT发现后,通过横支气管肺活检证实了诊断.
主要成果:
- 患者的骨髓病变是IVLBCL的唯一初始表现.
- 晚些时候在疾病过程中检测到肺部参与与地面玻璃不透明度和FDG狂热.
- 用R-CHOP化疗和高剂量甲状腺素治疗导致症状改善,并在PET/CT上产生完整的代谢反应.
结论:
- 骨髓病变可能是IVLBCL的唯一表现特征,需要广泛的差异诊断.
- 及时诊断和多模式治疗,包括化疗,对于治疗与神经复杂症相关的IVLBCL至关重要.
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