T-cell lymphoblastic lymphoma presenting with pleural effusion: A case report.
T-cell lymphoblastic lymphoma presenting with pleural effusion: A case report.
复制标题
伴有胸腔积液的 T 细胞淋巴母细胞淋巴瘤：病例报告。
DOI：
10.1016/j.rmcr.2014.04.003
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发表时间：
2014
影响因子：
1.1
通讯作者：
Zhou, Qiong
中科院分区：
文献类型：
--
作者：
He, Xin-Liang;Yu, Fan;Guo, Tao;Xiang, Fei;Tao, Xiao-Nan;Zhang, Jian-Chu;Zhou, Qiong
成人淋巴母细胞淋巴瘤（LBL）是一种侵袭性的非霍奇金淋巴瘤，主要发生于青少年和年轻成年男性，占所有非霍奇金淋巴瘤的1%至2%。与B-LBL相比，t细胞LBL更为常见，占成人疾病的90%。纵隔肿块、胸膜和/或心包积液是T-LBL的主要特征。我们报告一个18岁的男性胸膜积液，纵隔肿块，轻度心包积液，和一个正常的血象。胸膜积液的细胞学初步提示恶性肿瘤，但明确的诊断尚不清楚。胸腔镜检查后，选取部分胸膜，免疫表型研究显示：CD3+、TdT+、CD99+、CD20−。患者最终被诊断为T-LBL，仅6个月后死亡。该病例强调医学胸腔镜是胸膜疾病安全准确的诊断方法，部分胸膜活检和免疫分型是正确诊断LBL的必要条件。
Adult lymphoblastic lymphoma (LBL) is an aggressive form of non-Hodgkin lymphoma occurring in predominantly adolescent and young adult men, accounting for 1% to 2% of all non-Hodgkin's lymphomas. In contrast to B-LBL, T-cell LBL is much more common, accounting for up to 90% of disease in adults. Mediastinal mass, pleural and/or pericardial effusions are the major characteristics of T-LBL. We report an 18-year-old male with a pleural effusion, mediastinal mass, a light pericardial effusion, and a normal hemogram. The cytology of the pleural effusion initially suggested malignancy, but definitive diagnosis was unclear. After a medical thoracoscopy, the partial pleura was picked and immunophenotypic study revealed the following: CD3+, TdT+, CD99+, CD20−. The patient was finally diagnosed with T-LBL and died only 6 months after that. The case highlight the point that medical thoracoscopy is a safe and accurate diagnostic procedure for pleural diseases, and partial pleura biopsy with immunophenotyping was essential for achieving the correct diagnosis of LBL.