Early diagnosis of recurrent diffuse large B-cell lymphoma showing intravascular lymphoma by random skin biopsy
Early diagnosis of recurrent diffuse large B-cell lymphoma showing intravascular lymphoma by random skin biopsy
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DOI：
10.1111/j.1346-8138.2010.01127.x
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发表时间：
2011-06-01
影响因子：
3.1
通讯作者：
Takigawa, Masahiro
中科院分区：
文献类型：
--
作者：
Kasuya, Akira;Hashizume, Hideo;Takigawa, Masahiro
一位66岁男性因不明原因发热2周，乳酸脱氢酶和C反应蛋白水平升高入院。在这一事件发生的六年前，他患上了弥漫性大B细胞淋巴瘤，并通过放化疗成功治疗。虽然怀疑弥漫性大B细胞淋巴瘤复发，但影像学检查既无淋巴结病也无肿瘤形成。正常腹部皮肤随机活检显示皮下组织血管腔内广泛浸润CD 20+、CD 79 a+、CD 3-非典型淋巴细胞。这些发现使我们诊断为血管内B细胞淋巴瘤。利妥昔单抗联合环磷酰胺、阿霉素、长春新碱和泼尼松龙治疗后，高热消退，乳酸脱氢酶和C反应蛋白水平恢复至正常范围。结论：随机皮肤活检有助于血管内B细胞淋巴瘤的早期诊断。
A 66-year-old man was admitted to our hospital presenting 2 weeks' history of fever of unknown origin with elevated levels of lactate dehydrogenase and C-reactive protein. Six years before this episode, he had developed diffuse large B-cell lymphoma, which had been successfully treated with chemoradiation. While recurrence of diffuse large B-cell lymphoma was suspected, there was neither lymphadenopathy nor tumor formation by the imaging study. Random biopsy from normal-appearing abdominal skin showed extensive infiltration of CD20+, CD79a+, CD3- atypical lymphoid cells in the lumen of vessels in subcutaneous tissues. These findings led us to the diagnosis of intravascular B-cell lymphoma. Following rituximab plus cyclophosphamide, adriamycin, vincristine and prednisolone therapy, high fever subsided, and lactate dehydrogenase and C-reactive protein levels returned to the normal range. In conclusion, random skin biopsy is useful for the early diagnosis of intravascular B-cell lymphoma.