Yago Kazuhiro, Yanagita Soshi, Aono Maki, Matsuo Ken, Shimada Hideto
Department of Internal Medicine, Shizuoka General Hospital.
Rinsho Ketsueki. 2009 Jun;50(6):499-502.
A 76-year-old man presented with fever of unknown origin and renal dysfunction. Laboratory examination revealed anemia, thrombocytopenia, hypoalbuminemia, proteinuria, and elevations of C-reactive protein, lactic dehydrogenase, creatinine and ferritin. (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging showed FDG accumulation in the renal cortex and spleen. Based on the imaging study, renal biopsy was performed and histological diagnosis of intravascular large B-cell lymphoma (IVLBCL) was made. Renal impairment due to IVLBCL is uncommon and is often difficult to diagnose early. FDG-PET/CT may be a useful tool for the early diagnosis of IVLBCL.
一名76岁男性因不明原因发热和肾功能不全就诊。实验室检查显示贫血、血小板减少、低白蛋白血症、蛋白尿,以及C反应蛋白、乳酸脱氢酶、肌酐和铁蛋白升高。(18)F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDG-PET/CT)成像显示肾皮质和脾脏有FDG积聚。基于影像学检查结果,进行了肾活检,组织学诊断为血管内大B细胞淋巴瘤(IVLBCL)。IVLBCL导致的肾功能损害并不常见,且早期常难以诊断。FDG-PET/CT可能是IVLBCL早期诊断的有用工具。