Miyata A, Yoshino T, Kojima K, Fujii S, Kikuchi T
Department of Internal Medicine, Chugoku Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuyama City.
Rinsho Ketsueki. 2001 Jan;42(1):47-50.
We describe a case of T-cell prolymphocytic leukemia (T-PLL) in a 76-year-old man, who developed diffuse large B-cell lymphoma (DLBL) of the stomach, a previously unreported occurrence. The patient was referred to our hospital because of marked leukocytosis (40,000/microliter) without clinical symptoms. He was diagnosed as having T-PLL on the basis of the characteristic cell morphology and immunophenotype (CD2+, CD3+, CD4+, CD5+, CD7+, CD8-, CD25-, TCR alpha/beta+), but cytogenetic analysis showed no abnormalities. Fifteen months later, he developed a gastric tumor. Biopsy of the tumor revealed DLBL without features of MALT lymphoma; Helicobacter pylori was not detected. Chemotherapy eradicated the tumor, whereas the T-PLL was resistant to the therapy. The disease showed an indolent course for about 2 years thereafter. Immunological derangement due to T-PLL might have potentiated the development of DLBL in this case.
我们报告一例76岁男性的T细胞幼淋巴细胞白血病（T-PLL），该患者发生了胃弥漫性大B细胞淋巴瘤（DLBL），这是一种此前未被报道过的情况。该患者因显著白细胞增多（40,000/微升）但无临床症状而转诊至我院。基于特征性的细胞形态和免疫表型（CD2+、CD3+、CD4+、CD5+、CD7+、CD8-、CD25-、TCRα/β+），他被诊断为T-PLL，但细胞遗传学分析未显示异常。15个月后，他出现了胃部肿瘤。肿瘤活检显示为DLBL，无黏膜相关淋巴组织淋巴瘤特征；未检测到幽门螺杆菌。化疗消除了肿瘤，而T-PLL对该治疗耐药。此后，疾病呈惰性病程约2年。在该病例中，T-PLL导致的免疫紊乱可能促进了DLBL的发生。
