Mertz L E, Conn D L
Mayo Clinic Scottsdale, Arizona.
Curr Opin Rheumatol. 1992 Feb;4(1):39-46.
A large variety of vasculopathic syndromes are uncommonly associated with malignancies. Vasculitis is usually manifested by skin lesions and is generally associated with hematologic malignancies rather than solid tumors. Evidence of autoantibodies, immune complexes, and complement consumption is typically absent. Myelodysplastic syndromes can be confidently linked to vasculitis on the basis of recent literature. The temporal relationship of malignancy to vasculitis development is variable except that vasculitis generally follows the discovery of hairy cell leukemia and splenectomy. Vasculitis may occasionally be a complication of chemotherapy, radiation therapy, and bone marrow transplantation. Occasionally, malignant disorders may mimic vasculitic syndromes. The etiopathogenesis of vasculitis in patients with malignant disorders is unknown. The recent literature on vasculitis and malignancy addresses predominantly case reports and small patient cohorts and identifies clinical characteristics rather than pathogenic mechanisms.
多种血管病变综合征与恶性肿瘤的关联并不常见。血管炎通常表现为皮肤病变，一般与血液系统恶性肿瘤而非实体瘤相关。通常不存在自身抗体、免疫复合物及补体消耗的证据。根据近期文献，骨髓增生异常综合征可明确与血管炎相关。除血管炎一般在毛细胞白血病确诊及脾切除术后出现外，恶性肿瘤与血管炎发生的时间关系并不固定。血管炎偶尔可能是化疗、放疗及骨髓移植的并发症。偶尔，恶性疾病可能酷似血管炎综合征。恶性疾病患者血管炎的发病机制尚不清楚。近期关于血管炎与恶性肿瘤的文献主要涉及病例报告和小患者队列，并确定了临床特征而非致病机制。
