在慢性淋巴细胞白血病中偶发的同时发生的白内障腺癌与尾淋巴瘤
Lakshay Singla1, Ramya Kalaiselvan
1Department of General Surgery, Whiston Hospital, Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, England, UK.
Journal of minimal access surgery
|November 24, 2025
概括
在慢性淋巴细胞白血病 (CLL) 患者中,一种罕见的结肠癌和尾淋巴瘤病例突出了诊断挑战. 手术切除和向治疗导致了这个老年患者的良好结果.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 血液学 血液学 血液学
背景情况:
- 同时发生的结肠腺癌和尾淋巴瘤在慢性淋巴细胞白血病 (CLL) 患者中异常罕见.
- 这种双重病理带来了重大的诊断和治疗挑战,特别是在患有并发症的老年人中.
- 里希特变异是CLL中已知的并发症,但其与同步结直肠癌的关联尚未得到充分证实.
研究的目的:
- 报告一个不寻常的同时存在的状腺癌和尾扩散大B细胞淋巴瘤 (DLBCL) 的病例,该病例发生在一名患有CLL的87岁男性身上.
- 讨论老年患者双重恶性瘤的诊断和管理复杂性.
- 强调考虑患有胃肠道症状的CLL患者的并发病理的重要性.
主要方法:
- 一个87岁的男性被诊断出患有CLL的病例报告.
- 诊断工作包括成像,结肠镜与活检以及随后的腹腔镜右半结肠切除术.
- 组织病理学检查证实了腺癌和同步DLBCL,与里希特转换一致.
- 手术后的管理涉及ibrutinib和手术重新切割,以防止静脉复发.
主要成果:
- 组织病理学揭示了中度差异化的腺癌 (pT3N0M0) 和尾DLBCL,其中包括介质结节.
- 该患者在手术后1.5年经历了一次静脉复发,通过腹腔镜重新切割成功管理.
- 在多学科护理下,患者在初始手术后3年保持无疾病状态.
结论:
- 这一案例强调了在出现胃肠道问题的CLL患者中怀疑双重病理的必要性.
- 积极的手术管理与适当的血液学治疗和警监测相结合,可以实现有利的结果.
- 多学科合作对于管理老年患者复杂的瘤和血液病症至关重要.
关键词:
附录淋巴瘤 淋巴瘤里克特的转换.白细胞腺癌.慢性淋巴细胞白血病慢性淋巴细胞白血病laparoscopic hemicolectomy laparoscopic hemicolectomy laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic laparoscopic 是一项腹腔切除术,这项切除术的目的目的目的是如何切除腹腔?
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