淋巴瘤合并新型冠状病毒肺炎1例并文献复习

Lymphoma with COVID-19: a case report and literature review

目的探讨淋巴瘤合并新型冠状病毒肺炎(COVID-19)的临床特点、诊治方法和经验。方法报告1例滤泡淋巴瘤(FL)合并COVID-19病人,并复习相关文献,总结其临床特点、诊治经过及治疗经验。结果病人确诊为FL,经免疫化学治疗后出现不明原因的咳嗽伴发热,影像学表现不典型,多次新型冠状病毒(SARS-CoV-2)核酸检测阴性,最终通过逆转录-聚合酶链反应及下一代测序技术确诊SARS-CoV-2感染,经Paxlovid抗SARS-CoV-2、免疫球蛋白提高免疫力及糖皮质激素抗炎等治疗后体温降至正常,肺部感染较前吸收好转,效果显著。结论FL合并COVID-19病情复杂,病程较长,影像学表现不典型,较易漏诊,病死率相对较高,早期诊断和积极治疗可获得较好的预后。

Objective To analyzelymphoma with COVID-19 from the aspects of clinical features,diagnosis and treatment methods,and related experience.Methods This article reports a patient with follicular lymphoma(FL)comorbid with COVID-19,and a literature review is performed to summarize its clinical features,diagnosis and treatment processes,and treatment experience.Results The patient was diagnosed with FL and developed unexplained cough and pyrexia after immunochemotherapy,with atypical imaging manifestations and negative results from multiple SARS-CoV-2 nucleic acid tests,and finally a confirmed diagnosis of SARS-CoV-2 infection was madeby RT-PCR and next-generation sequencing.After treatment with Paxlovidfor SARS-CoV-2,immunoglobulin to improve immunity,and glucocorticoids to alleviate inflammation,body temperature returned to normal,and pulmonary infection was absorbed and improved,with a marked clinical effect.ConclusionFL comorbid with COVID-19 often has complex conditions,a long disease course,and atypical imaging manifestations,which may lead to missed diagnosis and a relatively high mortality rate.Early diagnosis and active treatment can help patients achieve better outcomes.