Sadamura S, Chihara T, Shibata K, Nishimura J, Nawata H, Nakagaki M, Masuda Y, Ohshima K, Kikuchi M
Third Department of Internal Medicine, Faculty of Medicine, Kyushu University.
Rinsho Ketsueki. 1991 Jan;32(1):34-8.
We describe a case of intestinal T-cell lymphoma which was histologically diagnosed of malignant histiocytosis of the intestine. A 47-year-old man was admitted to our hospital because of fever and generalized lymphadenopathy. Mild anemia, leukocytosis, positive CRP and a high level of LDH were noted. Pathological finding of the lymph node was compatible with dermatopathic lymphadenopathy with a slight increase in atypical lymphoid cells. At the 14th day after admission, he suffered from abdominal pain and was diagnosed as having perforative peritonitis. In laparotomy, the infiltration of histiocyte-like atypical cells were found around a site of small perforation of the terminal ileum. The findings were compatible with that of malignant histiocytosis of the intestine (MHI). He had recurrent perforations of the small intestine and died of peritonitis and sepsis at the 42nd day. Southern blot analysis of the biopsied lymph node showed TCR-beta gene rearrangement. Some patients diagnosed clinically and pathologically as having MHI may have a T-cell lymphoma like our case.
我们描述了一例肠道T细胞淋巴瘤病例，该病例在组织学上被诊断为肠道恶性组织细胞增多症。一名47岁男性因发热和全身淋巴结肿大入院。发现有轻度贫血、白细胞增多、CRP阳性及乳酸脱氢酶水平升高。淋巴结的病理检查结果与皮肤型淋巴结病相符，非典型淋巴细胞略有增加。入院第14天，他出现腹痛，被诊断为穿孔性腹膜炎。在剖腹手术中，在回肠末端小穿孔部位周围发现了组织细胞样非典型细胞浸润。这些发现与肠道恶性组织细胞增多症（MHI）相符。他小肠反复穿孔，在第42天死于腹膜炎和败血症。对活检淋巴结进行的Southern印迹分析显示TCR-β基因重排。一些临床和病理诊断为MHI的患者可能像我们的病例一样患有T细胞淋巴瘤。
