双肺移植后早期EB病毒阴性弥漫大B细胞淋巴瘤1例  

Early onset Epstein-Barr virus-negative diffuse large B cell lymphoma after bilateral lung transplantation:a case report

作　　者：王诗尧 李振玲[2] 富丽萍 钟定荣 陈文慧[5] Wang Shiyao;Li Zhenling;Fu Liping;Zhong Dingrong;Chen Wenhui(Department of Pulmonary and Critical Care Medicine,China-Japan Friendship Hospital National Center for Respiratory Medicine National Clinical Research Center for Respiratory Diseases Institute of Respiratory Medicine,Chinese Academy of Medical Sciences Beijing 100029,China;Department of Hematology,China-Japan Friendship Hospital Beijing 100029,China;Department of Nuclear Medicine,China-Japan Friendship Hospital Beijing 100029,China;Department of Pathology,China-Japan Friendship Hospital Beijing 100029,China;Department of Lung Transplantation,China-Japan Friendship Hospital National Center for Respiratory Medicine National Clinical Research Center for Respiratory Diseases Institute of Respiratory Medicine,Chinese Academy of Medical Sciences Beijing 100029,China)

机构地区：[1]中日友好医院呼吸与危重症医学科,国家呼吸医学中心,国家呼吸临床研究中心,中国医学科学院呼吸病学研究院,北京100029 [2]中日友好医院血液科,北京100029 [3]中日友好医院核医学科,北京100029 [4]中日友好医院病理科,北京100029 [5]中日友好医院肺移植科,国家呼吸医学中心,国家呼吸临床研究中心,中国医学科学院呼吸病学研究院,北京100029

出　　处：《中华结核和呼吸杂志》2022年第3期289-292,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：实体器官移植后发生淋巴瘤属于移植后淋巴增殖性疾病(PTLD)的一种。本文报道1例双肺移植后10个月余、以间断发热为首要表现的EB病毒阴性弥漫大B细胞淋巴瘤,同时合并噬血细胞综合征,给予利妥昔单抗联合依托泊苷化疗后,实现完全缓解。Lymphoma after solid organ transplantation is one of the manifestations of post-transplant lymphoproliferative disorders(PTLD).Here we reported a 39-year-old male patient presented with intermittent fever,markedly elevated level of peripheral blood lymphocytes and lactate dehydrogenase(LDH),rapid decrease in hemoglobin and platelet count ten months after bilateral lung transplantation.After systematic evaluation,the patient excluded infectious diseases.Positron emission tomography-computed tomography(PET/CT)revealed diffuse increasing of standard uptake value in bones throughout the body.The bone marrow aspiration,flow cytometric analysis and histopathology confirmed the diagnosis of diffuse large B-cell lymphoma(DLBCL)with negative Epstein-Barr virus-encoded small RNA(EBER)hybridization in situ.Meanwhile,complicated hemophagocytic lymphohistiocytosis was also diagnosed in the patient based on hypertriglyceridemia,abnormally elevated level of serum ferritin and solvable CD25(sCD25).Treatment regimen included reduction of immunosuppression,anti-CD20 antibody(CD20+B cell inhibitor,rituximab)and etoposide.Repeated PET/CT and bone marrow biopsy showed complete remission of lymphoma after 4 months of therapy.

关 键 词：肺移植 淋巴组织增殖性疾病 淋巴瘤 

分 类 号：R733.1[医药卫生—肿瘤]