Matone J, Lopes Filho G D, Scalabrin M, Ricca A B, Sato N Y
Surgery Department, Escola Paulista de Medicina, Federal University of São Paulo, Brazil.
Int Surg. 2000 Jul-Sep;85(3):248-51.
Primary splenic lymphoma is uncommon, constituting only 1-2% of all patients with malignant lymphoma. Despite the rarity of this malignancy, the number of primary splenic lymphoma being reported has increased due to its ambiguous definition used in the literature. We describe a case of a 41-year-old man with chronic hepatitis C virus infection presenting abdominal discomfort in the upper left quadrant, weakness, nausea and vomiting. Abdominal computed tomography revealed nodules in the congested splenic parenchyma. Splenectomy was performed and an analysis of the spleen diagnosed B-cell non-Hodgkin's lymphoma. Biopsy of the liver showed evidence of hepatitis C virus. Bone marrow biopsy revealed no tumor infiltration. The patient has been followed to date, has progressed quite well and remains essentially asymptomatic. Recently, an etiologically important role has been suggested for hepatitis C virus infection in the development of B-cell non Hodgkin's lymphoma. Lymphotropism of hepatitis C virus may play a pathological role in the development of non Hodgkin's lymphoma. It is important to add lymphoma to the list of differential diagnosis of extrahepatic disorders in patients with chronic hepatitis C virus infection.
原发性脾淋巴瘤并不常见，仅占所有恶性淋巴瘤患者的1%-2%。尽管这种恶性肿瘤罕见，但由于文献中对其定义不明确，报道的原发性脾淋巴瘤病例数量有所增加。我们描述了一例41岁慢性丙型肝炎病毒感染男性患者，出现左上腹不适、乏力、恶心和呕吐症状。腹部计算机断层扫描显示充血的脾实质内有结节。进行了脾切除术，对脾脏的分析诊断为B细胞非霍奇金淋巴瘤。肝脏活检显示有丙型肝炎病毒感染证据。骨髓活检未发现肿瘤浸润。该患者至今一直在随访中，病情进展良好，基本无症状。最近，有研究表明丙型肝炎病毒感染在B细胞非霍奇金淋巴瘤的发生中具有重要的病因学作用。丙型肝炎病毒的嗜淋巴细胞性可能在非霍奇金淋巴瘤的发生中起病理作用。对于慢性丙型肝炎病毒感染患者，将淋巴瘤纳入肝外疾病的鉴别诊断清单很重要。
