EB病毒阳性不一致性淋巴瘤1例并文献复习  

EB virus⁃positive discordant lymphoma:report of 1 case and review of literature

作　　者：赵奕 夏园 张晓旭 余孟莹 朱剑锋[1] Zhao Yi;Xia Yuan;Zhang Xiaoxu;Yu Mengying;Zhu Jianfeng(Department of Hematology,Taizhou People's Hospital Affiliated to Nantong University,Taizhou 225300,China)

机构地区：[1]南通大学附属泰州市人民医院血液科,泰州225300

出　　处：《白血病．淋巴瘤》2022年第3期170-173,共4页Journal of Leukemia & Lymphoma

基　　金：南通大学临床医学专项(2019JQ007);泰州市人民医院院级科研基金(ZL202032、ZL201920)。

摘　　要：目的探讨不一致性淋巴瘤(DL)的临床表现、实验室检查及诊疗特点。方法回顾性分析泰州市人民医院2019年11月收治的1例EB病毒阳性不一致性淋巴瘤患者的临床资料,并复习相关文献。结果患者起病时行颈部淋巴结活组织病理检查提示为血管免疫母细胞性T细胞淋巴瘤(AITL);后因消化道出血行肠道病灶切除术,术后病理提示弥漫大B细胞淋巴瘤(DLBCL),最终诊断为DL。予以R2-CHOP方案化疗,患者病程中反复出现消化道出血,一般情况较差,后患者拒绝化疗,改为来那度胺单药治疗。最终患者因多脏器衰竭死亡,总生存时间13个月。结论DL临床少见,而同时患AITL和DLBCL更为罕见,临床医生需提高对该病的认识,避免误诊和漏诊。Objective To investigate the clinical manifestations,laboratory tests,diagnosis and treatment of discordant lymphoma(DL).Methods The clinical data of a patient with EB virus-positive DL admitted to Taizhou People′s Hospital in November 2019 were retrospectively analyzed and the related literature was reviewed.Results The patient underwent a cervical lymph node biopsy pathology examination at onset,and then results suggested angioimmunoblastic T-cell lymphoma(AITL).The patient subsequently developed gastrointestinal bleeding and underwent resection of small bowel lesions,and postoperative pathology suggested diffuse large B-cell lymphoma(DLBCL).The patient was finally diagnosed as DL.The R2-CHOP chemotherapy regimen was given to the patient,but the patient still had recurrent gastrointestinal bleeding and poor general condition.The patient refused chemotherapy and was changed to lenalidomide monotherapy.Finally,the patient died due to multiorgan failure,with an overall survival of 13 months.Conclusions DL is rarely seen in lymphoma,whereas the combination of AITL and DLBCL is extremely rare.The clinicians need to improve the understanding of this disease to avoid misdiagnosis and missed diagnosis.

关 键 词：免疫母细胞淋巴结病 淋巴瘤 T细胞 淋巴瘤 大B-细胞 弥漫性 不一致性淋巴瘤 

分 类 号：R733.1[医药卫生—肿瘤]