慢性淋巴细胞白血病复杂的非肝硬化门高血压:尸检案例报告
Akiri Hiraide1, Keisuke Ojiro2,3, Kimihiro Matsumoto4
1Department of Gastroenterology and Hepatology, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa-shi, Chiba, 272-8513, Japan.
Clinical journal of gastroenterology
|July 16, 2025
概括
诸如慢性淋巴细胞白血病 (CLL) 这样的血液恶性瘤可能会导致非肝门高血压. 这一案例凸显了考虑到肝病以外的罕见病因对于准确的诊断和管理的重要性.
科学领域:
- 血液学 血液学 血液学
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
背景情况:
- 门高血压通常是由肝硬化引起的,但可以在没有肝纤维化的情况下发生.
- 血液恶性瘤,如慢性淋巴细胞白血病 (CLL),是非循环门高血压的罕见原因.
- 这种病例呈现了一个患有CLL的患者,他出现了严重的门门高血压症状.
研究的目的:
- 报告患有慢性淋巴细胞白血病 (CLL) 且没有肝纤维化病的患者患有门门高血压病例.
- 强调在血液恶性瘤的背景下对非肝硬化门高血压的诊断挑战和考虑.
- 讨论CLL患者门高血压的管理和结果.
主要方法:
- 一个70岁的老人患有CLL的病例报告.
- 临床表现包括大规模的脊髓巨变,食道水破裂和耐火性.
- 诊断工作包括弹性图,评估炎并发症,以及尸检结果.
- 干预包括部分动脉栓塞 (PSE) 用于门高血压管理.
主要成果:
- 患者出现了模仿肝硬化的症状,包括耐火性炎和水出血.
- 尸体解剖没有发现肝硬化或肝纤维化;门腔高血压是由于CLL细胞透导致大病和门静脉阻塞.
- 部分动脉栓塞 (PSE) 提供了暂时缓解.
- 患者在干预后因严重感染而死亡.
结论:
- 血液性恶性瘤,特别是CLL,应在非肝硬化门性高血压的差异诊断中考虑.
- 虽然PSE可以缓解症状,但在血液恶性瘤的免疫功能低下患者中,致命感染的风险是显著的.
- 组织学确认对于诊断门高血压的非典型表现至关重要.
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