原发心脏浆母细胞淋巴瘤一例报告并文献复习  

Primary cardiac plasmablastic lymphoma：report of a case and literature review

作　　者：朱剑锋[1] 李勤[1] 曾文前[1] 吴正东[1] 范磊[2] 徐卫[2] 李建勇[2] 

机构地区：[1]南通大学附属泰州市人民医院血液科,225300 [2]南京医科大学第一附属医院

出　　处：《中华血液学杂志》2015年第10期862-865,共4页Chinese Journal of Hematology

摘　　要：目的：探讨心脏原发浆母细胞淋巴瘤患者的临床特征、诊治方法与预后。方法报道1例心脏原发浆母细胞淋巴瘤患者的诊疗结果，结合文献复习，探讨该疾病的发病机制、诊断、治疗与预后特征。结果患者，男，57岁。行右心房肿瘤切除术，肿块位于右心房，病理组织检查示肿瘤性大细胞弥漫性增生，免疫组织化学检查示CD38＋、CD79a＋，病理诊断为：恶性淋巴瘤，浆母细胞性。给予DA-EPOCH（依托泊苷、长春新碱、脂质体阿霉素、环磷酰胺、泼尼松）方案、BEAM（卡莫司汀、依托泊苷、阿糖胞苷、马法兰）方案联合自体造血干细胞移植治疗。随访至2015年3月患者病情处于稳定状态。结论原发性心脏浆母细胞淋巴瘤罕见，病因尚不清楚，临床表现无特异性，确诊主要依靠病理及免疫组织化学检查，目前尚无标准治疗方案，多采用类似于侵袭性淋巴瘤治疗的方案，预后较差。Objective To report a case of primary cardiac plasmablastic lymphoma to investigate its clinical feature, diagnosis, therapy and prognosis. Methods A case of primary cardiac plasmablastic lymphoma was studied. The imaging examination, conventional histopathological and immunohistochemical staining of this case were detected. The clinical feature, pathogenesis, diagnosis, therapy and prognosis of primary cardiac plasmablastic lymphoma were further investigated through literatures review. Results The tumor was located in the right atrium. Microscopic examination showed diffuse proliferation of large lymphoid cells. The neoplastic cells were positive for CD38 and CD79a. The patient was treated with chemotherapy combined with autologous stem cell transplantation. Conclusions Primary cardiac plasmablastic lymphoma was extremely rare. Its pathogenesis remained to be unclear. With non- specific clinical manifestations, the diagnosis was mainly confirmed by histopathological and immunohistochemical staining method. Without standard treatment, more patients were treated with chemithreapy regimens similar to the treatment used in aggressine lymphoma. Patients usually had a poor prognosis.

关 键 词：淋巴瘤 大B细胞 弥漫性 心脏 原发性 

分 类 号：R732.1[医药卫生—肿瘤]