孤立的脏梗塞作为扩散大B细胞淋巴瘤的表现
Joshua Shadrach Daniel1, Noraidah Masir2, Wai Yee Chan3
1Internal Medicine, International Medical University, Kuala Lumpur, MYS.
Cureus
|November 27, 2025
概括
扩散性大B细胞淋巴瘤 (DLBCL) 很少表现为孤立的脏中风. 这一案例突出了诊断方面的挑战,并强调了PET/CT和活检对于准确评估和治疗DLBCL的重要性.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 放射学 放射学是指放射学
背景情况:
- 扩散性大B细胞淋巴瘤 (DLBCL) 是一种侵略性的非霍奇金淋巴瘤.
- 在DLBCL中脏参与可以以各种方式表现出来,但孤立的脏中风并不常见.
- 早期和准确的诊断对于有效管理DLBCL至关重要.
研究的目的:
- 报告一个罕见的DLBCL病例,呈现出孤立的脏中风.
- 为了说明正子发射断层扫描-计算机断层扫描 (PET/CT) 和活检在这种情况下的诊断效用.
- 讨论DLBCL与脏参与的管理和结果.
主要方法:
- 一个51岁男性的病例报告,胸部有多发性疼痛,发烧和体重减轻.
- 诊断工作包括成像研究 (PET/CT) 和淋巴结活检.
- 治疗包括R-CHOEP化疗,后来切换到R-CHOP,然后进行脊髓切除术.
主要成果:
- 活检证实DLBCL,非生殖中心亚型具有特定的分子标记 (BCL2/CMYC表达,高Ki67).
- 通过PET/CT检测出高代谢性缩大和脏中风.
- 治疗后的成像显示了持续的脊髓吸收,导致脊髓切除术没有残留疾病.
结论:
- 孤立的脏中风可能是DLBCL的罕见表现征兆.
- PET/CT和活检是诊断出现脏梗塞的DLBCL的重要工具.
- 在特定的DLBCL病例中,骨切除术可以成为成功的治疗选择,其中包括骨参与.
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