Shirai Tsuyoshi, Takahashi Reiko, Tajima Yumi, Kohata Katsura, Yamamoto Joji, Fujii Hiroshi, Takasawa Naruhiko, Ishizawa Kenichi, Ichinohasama Ryo, Ishii Tomonori, Harigae Hideo
Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai.
Intern Med. 2009;48(23):2041-5. doi: 10.2169/internalmedicine.48.2600. Epub 2009 Dec 1.
Here, we present a 54-year-old man with proptosis and swelling below the left eyelid. Laboratory findings showed high levels of PR3-ANCA and histological examination of the first biopsy revealed acute inflammation. Together with the findings of MRI, a diagnosis of WG was made. However, the disease progressed rapidly and histological examination of the second biopsy revealed infiltration of neoplastic T lymphocytes with aberrant loss of CD7. A final diagnosis of peripheral T cell lymphoma, not otherwise specified (WHO) was made, and complete remission was achieved by chemotherapy. This is a very rare case of T cell lymphoma with a high titer of PR3-ANCA.
在此,我们报告一名54岁男性,有左眼眼球突出及下眼睑肿胀。实验室检查结果显示PR3-ANCA水平升高,首次活检的组织学检查显示为急性炎症。结合MRI检查结果,诊断为韦格纳肉芽肿(WG)。然而,疾病进展迅速,第二次活检的组织学检查显示肿瘤性T淋巴细胞浸润伴CD7异常缺失。最终诊断为外周T细胞淋巴瘤,非特指型(世界卫生组织分类),通过化疗实现了完全缓解。这是一例非常罕见的伴有高滴度PR3-ANCA的T细胞淋巴瘤病例。