NEJM:结外自然杀伤T细胞淋巴瘤-病例报道

2020-02-06 xing.T MedSci原创

正电子发射断层扫描(PET)显示,鼻咽、纵隔、腹部、骨盆、睾丸和皮肤中的氟脱氧葡萄糖亲和力增加。患者EB病毒载量为18486U/ml。结外NK T细胞淋巴瘤是与EB病毒相关的罕见肿瘤。

患者为一名53岁的男性,因反复发热、呼吸困难和快速进行性皮肤病变1个月而到急诊科就诊。

体格检查显示背部、躯干和四肢有疼痛性硬结节,周围紫色变色(如图A所示)。实验室检查发现白细胞计数为每立方毫米3000(参考范围3400至9100),血小板计数为每立方毫米36000(参考范围150000至450000)和铁蛋白水平超过40000ng/ml(参考范围:22至275)。骨髓抽吸物检查发现噬红细胞作用,从皮肤病变处获得的活检标本发现结外自然杀伤(NK)T细胞淋巴瘤。正电子发射断层扫描(PET)显示,鼻咽、纵隔、腹部、骨盆、睾丸和皮肤中的氟脱氧葡萄糖亲和力增加。患者EB病毒载量为18486U/ml。结外NK T细胞淋巴瘤是与EB病毒相关的罕见肿瘤。



该患者接受了包含吉西他滨、顺铂、地塞米松和天冬酰胺酶六个疗程的全身化疗。在8个月的随访中,他的皮肤状况有了显著改善(如图B所示),并且无法检测到EB病毒。

在复查的PET扫描中发现氟脱氧葡萄糖亲和力病变消退。
 
原始出处:

Kuan-Yu Chi,et al.Extranodal Natural Killer T-Cell Lymphoma.N Engl J Med 2020;https://www.nejm.org/doi/full/10.1056/NEJMicm1910000

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