以腹水为首发症状的Burkitt淋巴瘤1例并文献复习  

Burkitt lymphoma presenting with ascites as the initial symptom:A case report and literature review

作　　者：赵育新 吴仕收 杨平[1] 于国华[1] ZHAO Yuxin;WU Shishou;YANG Ping;YU Guohua(Department of Pathology,Affiliated Yantai Yuhuangding Hospital,Qingdao University,Yantai Shandong 264000,China)

机构地区：[1]青岛大学附属烟台毓璜顶医院病理科,山东烟台264000

出　　处：《临床与病理杂志》2024年第4期636-641,共6页Journal of Clinical and Pathological Research

基　　金：山东省自然科学基金(ZR2022MH297)。

摘　　要：报告1例以腹水为首要症状的Burkitt淋巴瘤患者的临床与病理资料,并复习相关文献。该患者为29岁男性,因腹胀、乏力20 d入院。体格检查示:腹部膨隆,移动性浊音(+)。影像学检查示:腹膜广泛增厚并有大量腹水,腹膜^(18)F-氟代脱氧葡萄糖(^(18)F-fluorodeoxyglucose,^(18)F-FDG)代谢增高。腹腔穿刺示:腹水浑浊呈橘黄色,李凡他试验(+),单核细胞为98.9%,乳酸脱氢酶为1214 U/L。将腹水离心制作细胞蜡块,行切片及苏木精-伊红染色(hematoxylin-eosin staining,HE),免疫组织化学染色及荧光原位杂交技术确诊为Burkitt淋巴瘤。行利妥昔单抗联合抗超分割环磷酰胺、长春新碱、多柔比星和地塞米松(rituximab-hyperfractionated cyclophosphamide,vincristine adriamycin,and dexamethasone,R-Hyper CVAD)方案化学治疗后,患者病情获得临床完全缓解。随访25个月,患者生存状况良好,未见复发和转移。Burkitt淋巴瘤的诊断高度依赖于病理学检查,起病急,进展快,生物学行为恶性程度高,需予以重视。分子检测对其诊断和鉴别诊断必不可少,及时正确诊断和治疗对患者的预后至关重要。The clinical and pathological data of a case of Burkitt lymphoma with ascites as the primary clinical manifestation were reported.In addition,relevant literature was reviewed.The patient,a 29-year-old male,was admitted with abdominal distension and fatigue for 20 days.Physical examination demonstrated abdominal distension with positive shifting dullness.Imaging examination showed extensive peritoneal thickening and large amounts of ascites,with increased metabolism of ^(18)F-fluorodeoxyglucose(^(18)F-FDG)in the peritoneum.Abdominal paracentesis revealed cloudy,orange-colored ascites,positive Rivalta test,98.9%monocytes,and lactate dehydrogenase(LDH)of 1214 U/L.Ctrospin preparations of ascites were stained with hematoxylin-eosin staining(HE),and immunohistochemistry and fluorescence in situ hybridization confirmed the diagnosis of Burkitt lymphoma.After chemotherapy with the R-Hyper CVAD regimen(rituximabhyperfractionated cyclophosphamide,vincristine,adriamycin and dexamethasone),the patient achieved complete clinical remission.After 25 months of follow-up,the patient remains in good health,with no recurrence or metastasis.The diagnosis of Burkitt lymphoma is highly dependent on pathology examination,characterized by rapid onset,aggressive progression,and high malignancy.Molecular testing is essential for diagnosis and differential diagnosis.Timely and accurate diagnosis and treatment are critical for patient prognosis.

关 键 词：BURKITT淋巴瘤 腹水 病理学 临床表现 

分 类 号：R733.1[医药卫生—肿瘤]