不一致性淋巴瘤一例并文献复习

Discordant lymphoma: report of one case and review of literature

目的 探讨不一致性淋巴瘤患者的临床特点、诊治方法和预后.方法 回顾性分析战略支援部队特色医学中心收治的1例不一致性淋巴瘤患者的临床资料并进行相关文献复习.结果 该患者因发现血小板减少就诊,检查发现脾大,给予激素治疗后血小板回升,激素减量时出现血小板减少,行脾切除手术,术后病理诊断为脾边缘区淋巴瘤,给予观察,9个月后出现腋下淋巴结肿大,淋巴结病理活组织检查诊断为弥漫大B细胞淋巴瘤,给予免疫治疗联合化疗后病情缓解.结论 不一致性淋巴瘤患者罕见,临床无特殊表现,诊断需依据病理检查,免疫治疗联合化疗可能效果较好.

Objective To investigate the clinical characteristics, diagnosis, treatment and prognosis of discordant lymphoma. Methods The clinical data of one patient with discordant lymphoma at the PLA Strategic Support Force Characteristic Medical Center were retrospectively analyzed, and the related literatures were reviewed. Results The patient was treated for thrombocytopenia and the examination showed splenomegaly. After hormone treatment, the platelet rebounded and thrombocytopenia occurred during hormone reduction. Splenectomy was performed. Postoperative pathological diagnosis of splenic marginal lymphoma was made and observed. Axillary lymph node enlargement occurred nine months later. Pathological diagnosis of diffuse large B-cell lymphoma was made by using lymph node biopsy, and the disease condition was alleviated after immunotherapy combined with chemotherapy. Conclusions Discordant lymphoma is rare and shows no special clinical manifestations. Its diagnosis should rely on pathological examination. Immunotherapy combined with chemotherapy may be more effective.