III Medical Department, Klinikum rechts der Isar, Technical University Munich, Ismaningerstrasse 22, 81675 München, Germany.
Nat Rev Clin Oncol. 2010 Feb;7(2):116-9. doi: 10.1038/nrclinonc.2009.218.
A 71-year-old male patient was diagnosed as having a KIT-positive gastrointestinal stromal tumor located at the gastric antrum. With no signs of distant metastasis, the patient primarily underwent gastric surgery with antrectomy and Billroth-I-reconstruction. Owing to tumor size and mitotic index, the patient was considered at high risk of tumor relapse and thus was entered into a clinical trial to receive adjuvant imatinib treatment. 4 months after initiation of imatinib treatment, the patient presented with several newly discovered subcutaneous and intra-abdominal tumor lesions. Imatinib treatment had been tolerated well until then.
Physical examination, blood tests, biopsies of the subcutaneous tumor lesions, tumor morphology and immunohistochemistry, PCR for the T-cell receptor gamma genes, sequential CT and PET-CT.
Monoclonal T-cell lymphoproliferative disorder, potentially induced by imatinib.
Imatinib was stopped, after which the tumor lesions spontaneously regressed and, eventually, complete remission was achieved.
一位 71 岁男性患者被诊断为胃窦部 KIT 阳性胃肠道间质瘤。由于无远处转移迹象，患者主要接受了胃切除术加毕罗氏 I 式重建术。由于肿瘤大小和有丝分裂指数，患者被认为有很高的肿瘤复发风险，因此进入了一项临床试验，接受辅助伊马替尼治疗。伊马替尼治疗开始后 4 个月，患者出现了几个新发现的皮下和腹腔内肿瘤病变。在此之前，伊马替尼治疗耐受良好。
体格检查、血液检查、皮下肿瘤病变活检、肿瘤形态和免疫组织化学、T 细胞受体γ基因 PCR、连续 CT 和 PET-CT。
单克隆 T 细胞淋巴增生性疾病，可能由伊马替尼引起。
停用伊马替尼后，肿瘤病变自发消退，最终达到完全缓解。
