SASAKI Takahide, OHNISHI Shunsuke, ONISHI Reizo, TAKEMURA Ryou, KOBAYASHI Yoshimitsu, SUZUKI Mio, DAZAI Masayoshi, HATA Tamotsu, YAMAMOTO Junji, ODA Hisashi, TAKAHASHI Tatsuro, OGASAWARA Kazuhiro, MIYAGISHIMA Takuto
Department of Internal Medicine, Kushiro Rosai Hospital.
Rinsho Ketsueki. 2009 Nov;50(11):1621-5.
A 59-year-old woman presented with ascites and intraperitoneal lymph node swelling. Pathological examination of the lymph node revealed follicular lymphoma. After a lymph node biopsy, she developed atypical genital bleeding, multiple endocrine disorders, polyneuropathy with a high plasma level of vascular endothelial growth factor (VEGF), and was diagnosed with POEMS syndrome. Following administration of methyl prednisolone, ascites immediately decreased and her performance status improved; however, about 18 months later, renal failure occurred, and she died despite increased steroid dosage. Lymph node swelling is often found in POEMS syndrome; however, its histological appearance is not well known, and it is very rare to be concomitant with malignant lymphoma. Therefore, it is important to perform a lymph node biopsy and investigate it in relation with VEGF.
一名59岁女性出现腹水和腹膜后淋巴结肿大。淋巴结病理检查显示为滤泡性淋巴瘤。淋巴结活检后，她出现了非典型生殖器出血、多种内分泌紊乱、伴有高血浆血管内皮生长因子（VEGF）水平的多发性神经病变，并被诊断为POEMS综合征。给予甲泼尼龙后，腹水立即减少，其身体状况得到改善；然而，约18个月后，出现了肾衰竭，尽管增加了类固醇剂量，她仍死亡。淋巴结肿大在POEMS综合征中经常被发现；然而，其组织学表现尚不为人所知，并且与恶性淋巴瘤同时存在的情况非常罕见。因此，进行淋巴结活检并研究其与VEGF的关系很重要。
