Terasaki Yasushi, Okumura Hirokazu, Ishiura Yoshihisa, Yokawa Shigeru, Kuribayashi Masato, Kodama Koichi, Motoi Isamu, Sugihara Masami, Saito Katsuhiko, Tanaka Takehiro, Yoshino Tadashi, Ohtake Shigeki, Nakao Shinji
Division of Internal Medicine, Toyama City Hospital.
Rinsho Ketsueki. 2008 Jan;49(1):30-4.
A 64-year-old woman visited our hospital in December 2005 because of general malaise. Her hemoglobin level was 9.0 g/dl. Gastrointestinal fiberscopy detected a hemorrhagic gastric ulcer, which was considered as etiology of anemia. Abdominal ultrasonography showed bilateral hydronephroses and hydroureters. A urine test revealed pyuria and macroscopic hematuria, and urine culture revealed 10(8) colony-forming units of Escherichia coli per ml. Pelvic MRI showed thickening of the posterior wall and trigone of the urinary bladder. Transurethral resection was peformed, and biopsy of the mucous of the bladder gave a diagnosis of primary mucosa-associated lymphoid tissue (MALT) lymphoma of the urinary bladder. Ann Arbor clinical stage was IEA. It was planned to administer irradiation at a total dose of 36 Gy to the whole bladder and part of the tumor; however, radiotherapy was discontinued at a dose of 26 Gy because of the development of pollakisuria. Pelvic MRI and pathologic examination of the urinary bladder after radiotherapy showed that the lymphoma was in complete remission; however, she received retuximab therapy at a dose of 375 mg/m2/week, 8 times additionally, because of the reduced radiotherapy. The patient has remained in complete remission for 14 months.
一名64岁女性因全身不适于2005年12月就诊于我院。她的血红蛋白水平为9.0 g/dl。胃肠纤维内镜检查发现一个出血性胃溃疡，被认为是贫血的病因。腹部超声显示双侧肾盂积水和输尿管积水。尿液检查显示脓尿和肉眼血尿，尿培养显示每毫升有10⁸个大肠杆菌菌落形成单位。盆腔磁共振成像显示膀胱后壁和三角区增厚。进行了经尿道切除术，膀胱黏膜活检诊断为原发性膀胱黏膜相关淋巴组织（MALT）淋巴瘤。Ann Arbor临床分期为IEA期。计划对整个膀胱和部分肿瘤给予36 Gy的总剂量照射；然而，由于尿频的出现，放疗在26 Gy时中断。放疗后盆腔磁共振成像和膀胱病理检查显示淋巴瘤完全缓解；然而，由于放疗剂量减少，她额外接受了8次剂量为375 mg/m²/周的利妥昔单抗治疗。该患者已完全缓解14个月。
