Splenic Diffuse Red Pulp Small B-Cell Lymphoma with Gastrointestinal Hemorrhage: A Case Report and Literature Review.
Splenic Diffuse Red Pulp Small B-Cell Lymphoma with Gastrointestinal Hemorrhage: A Case Report and Literature Review.
复制标题
脾弥漫红髓小B细胞淋巴瘤伴胃肠道出血1例报告并文献复习
DOI：
10.2147/cmar.s275292
复制
发表时间：
2020
影响因子：
3.3
通讯作者：
Xu K
中科院分区：
文献类型：
--
作者：
Xu Y;Fan X;Sun C;Yin L;Qiu T;Xia J;Zhong X;Xu L;Li D;Li Z;Zhu F;Xu K
脾弥漫性红髓小 B 细胞淋巴瘤 (SDRPSBCL) 很罕见，占非霍奇金淋巴瘤的比例不到 1%。作为 SDRPSBCL 的首发症状或伴随症状，胃肠道出血（GIH）相当罕见。我们报道了一名 SDRPSBCL 并发 GIH 的患者。根据小肠镜、脾、肠病理切片、免疫组化等相关实验室检查，诊断为SDRPSBCL（IVb期）合并结肠、直肠溃疡。临床表现为便血、大便不成形、持续肛门疼痛、生活质量差。随后，患者接受了六周期的CHOP（环磷酰胺+阿霉素+长春新碱+氢泼尼松）方案治疗。回顾性分析其临床特点、诊断和治疗，并复习相关文献。第一个疗程化疗后，患者不再出现便血，大便成形。经过六个周期的化疗后，患者的肛门不再疼痛，根据正电子发射断层扫描CT结果，患者已完全缓解。通过对该病例的分析，可以阐明原发病缓解后，消化道出血程度减轻，为临床治疗该罕见病提供依据。
Splenic diffuse red pulp small B-cell lymphoma (SDRPSBCL) is rare and accounts for less than 1% of non-Hodgkin’s lymphoma. As the first or accompanying symptoms of SDRPSBCL, gastrointestinal hemorrhage (GIH) is rather unusual. We reported on a patient with SDRPSBCL complicated with GIH. According to the enteroscopy, pathological sections of spleen and intestine, immunohistochemistry and other related laboratory examinations, the patient was diagnosed as SDRPSBCL (stage IVb) complicated with colon and rectal ulcers. The clinical manifestations were hematochezia, unformed stool, continuous anal pain and poor quality of life. Subsequently, the patient was treated by six cycles of CHOP (cyclophosphamide + doxorubicin + vincristine + hydroprednisone) regimens. The clinical features, diagnosis and treatment were analyzed retrospectively and the relevant literatures were reviewed. After the first course of chemotherapy, the patient did not have any more bloody stool and the stool was shaped. After six cycles of chemotherapy, the patient’s anus was no longer painful and he has been in complete remission according to the result of positron emission tomography CT. Through analysis of this case, we could elucidate that after the primary disease was alleviated, the bleeding degree of digestive tract was relieved, which provided the basis for the clinical treatment of this rare disease.