初诊为咳嗽变异性哮喘的血管免疫母细胞性T细胞淋巴瘤一例及文献复习

Angioimmunoblastic T-cell lymphoma：a case report and review of literature

目的介绍1例初诊考虑为咳嗽变异性哮喘的血管免疫母细胞性T细胞淋巴瘤并复习相关文献，以提高临床医师对该病的认识。方法对1例确诊为血管免疫母细胞性T细胞淋巴瘤的患者诊治过程进行分析，结合文献讨论其临床特点、诊断及治疗，并分析其误诊原因。结果血管免疫母细胞性T细胞淋巴瘤是一种来源于滤泡辅助T细胞的非霍奇金淋巴瘤，发病率低，以中老年患者为多见，常以淋巴结肿大起病，可伴有发热等全身非特异性症状。淋巴结活检是确诊的重要依据。目前尚无统一的治疗方案，临床主要选用CHOP方案化疗。结论血管免疫母细胞性T细胞淋巴瘤常见多发淋巴结肿大，淋巴结压迫相邻气管、支气管可出现咳嗽等症状。系统查体有助于降低误诊、漏诊可能性。

Objective To raise awareness of angioimmunoblastic T-cell lymphoma （AITL） by one case of AITL and review of literature reports. Methods The clinic and follow-up data of one patient with AITL were analyzed, and clinical features, diagnosis and treatment of AITL were discussed combining with literature. Results AITL is derived from centro-follicular T-helper cells. It is characterized by generalized lymphacenopathy, fever, skin rash, anemia and autoimmune features are frequently described. The diagnosis of AITL needs clinical syndrome and morphology. Despite treatment with polychemotherapy,the prognosis is poor. Conclusions Peripheral nodes pressing bronchia in AITL patients may induce cough. System physical examination helps to reduce misdiagnosis.