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白塞病后颅内原发性恶性淋巴瘤——病例报告

[Intracranial primary malignant lymphoma following Behçet's disease--case report].

作者信息

Harada K, Ohtsuru K, Nakayama K, Takagi S, Sugita Y, Torigoe R

机构信息

Department of Neurosurgery, Omuta City Hospital.

出版信息

No To Shinkei. 1992 Nov;44(11):1029-33.

PMID:1296716
Abstract

We reported a case of intracranial primary malignant lymphoma following Behçet disease treated with colchicine. A 43-year-old female with a past history of oral ulcer and folliculitis visited the Department of Ophthalmology on December, 1990, because of her impaired visual acuity. A diagnosis of uveitis due to incomplete type Behçet disease was made from funduscopic examination and her past history. She had been received 1.0mg/day colchicine for six months in the outpatient clinic. She was referred to our department on August 19, 1991, with nausea and headache. On admission, neurological examination revealed slight right cerebellar ataxia showing dysmetria and dysdiadochokinesis. Computed tomography scan and magnetic resonance images demonstrated a malignant lymphoma in the left cerebellar hemisphere. Stereotaxic biopsy resulted in the B cell type malignant lymphoma (Diffuse large cell type). Galliumscintigraphy, physical examination and peripheral blood examination disclosed no systemic abnormalities. There was a reduction of lymphocyte's response to PHA (phytohemagglutinin) stimulation (1.24). The tuberculin reaction was negative. Colchicine was discontinued and the therapy with radiation and prednisolone (20 mg/day) was started under the diagnosis of intracranial primary malignant lymphoma. She was discharged without any neurological deficits on November 25, 1991. She still suffers from impaired visual acuity, but has no problems in daily life. To our knowledge no intracranial primary malignant lymphoma following Behçet disease has been reported previously. The relationship between Behçet disease treated with colchicine and the occurrence of malignant lymphoma is discussed. In our case we speculated that malignant lymphoma might have occurred in an immunosuppressive state due to administration colchicine.

摘要

我们报告了1例在用秋水仙碱治疗的白塞病后发生颅内原发性恶性淋巴瘤的病例。一名43岁女性,有口腔溃疡和毛囊炎病史,于1990年12月因视力下降就诊于眼科。根据眼底检查及既往病史,诊断为不完全型白塞病所致葡萄膜炎。她在门诊接受了6个月的每日1.0mg秋水仙碱治疗。1991年8月19日,她因恶心和头痛转诊至我科。入院时,神经系统检查发现右小脑轻度共济失调,表现为辨距不良和轮替运动障碍。计算机断层扫描和磁共振成像显示左小脑半球有一个恶性淋巴瘤。立体定向活检结果为B细胞型恶性淋巴瘤(弥漫大细胞型)。镓扫描、体格检查和外周血检查均未发现全身异常。淋巴细胞对PHA(植物血凝素)刺激的反应降低(1.24)。结核菌素反应为阴性。停用秋水仙碱,在颅内原发性恶性淋巴瘤的诊断下开始放疗和泼尼松龙(每日20mg)治疗。她于1991年11月25日出院,无任何神经功能缺损。她仍有视力下降,但日常生活无问题。据我们所知,此前尚无白塞病后发生颅内原发性恶性淋巴瘤的报道。本文讨论了用秋水仙碱治疗白塞病与恶性淋巴瘤发生之间的关系。在我们的病例中,我们推测恶性淋巴瘤可能是由于服用秋水仙碱导致免疫抑制状态而发生的。

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