Acute intracerebral hemorrhage in intravascular lymphoma - A serious infusion related adverse event of rituximab
Acute intracerebral hemorrhage in intravascular lymphoma - A serious infusion related adverse event of rituximab
复制标题
DOI：
10.1097/01.coc.0000182463.57861.3c
复制
发表时间：
2007-04-01
影响因子：
2.6
通讯作者：
Ganguly, Siddhartha
中科院分区：
文献类型：
--
作者：
Ganguly, Siddhartha
一名 20 岁女性因癫痫和视野缺损就诊于边远医院。她大脑的磁共振成像（MRI）显示多处皮质梗塞。她最初接受静脉注射类固醇治疗，推测诊断为中枢神经系统（CNS）血管炎。随后，立体定向脑活检显示 CD20 肿瘤性大 B 细胞堵塞了多个脑毛细血管的管腔（图 1 和图 2）。血管内淋巴瘤 (IVL) 是弥漫性大 B 细胞淋巴瘤的罕见变异型，其特征是肿瘤细胞在血管管腔内主要生长。大脑和皮肤是该疾病的两个最常见部位。诊断常常被延误，不幸的是，一些此类病例是在尸检后才被诊断出来的。及时脑活检是诊断这种罕见淋巴瘤的唯一方法。这种恶性肿瘤的病程通常进展迅速，最终致命，但联合化疗后获得持久缓解的一些患者除外。 1 利妥昔单抗联合 CHOP 化疗（R-CHOP）已成功用于一些 IVL 患者。 2
A20-year-old female presented to an outlying hospital with seizure and visual field defect. Magnetic resonance imaging (MRI) of her brain showed multiple cortical infarcts. She was initially treated with intravenous steroid for a presumed diagnosis of central nervous system (CNS) vasculitis. Later, stereotactic brain biopsy showed CD20 neoplastic large B cells occluding the lumina of several brain capillaries (Figs. 1 and 2).Intravascular lymphoma (IVL) is a rare variant of diffuse large B-cell lymphoma that is characterized by predominant growth of neoplastic cells within the lumina of blood vessels. Brain and skin are the 2 most common sites of the disease. Diagnosis is often delayed and unfortunately, several such cases are diagnosed after autopsy. Prompt brain biopsy is the only way to diagnose this rare lymphoma. The course of this malignancy is generally rapidly progressive and ultimately fatal, with the exception of some patients that achieve durable remission after combination chemotherapy. 1 Rituximab in combination with CHOP chemotherapy (R-CHOP) had been used successfully in some patients with IVL. 2