Nunes Joana, Tato Marinho Rui, Raposo João, Velosa José
Serviços de Gastrenterologia e Hepatologia e de Serviço de Hematologia, Hospital de Santa Maria, Lisboa.
Acta Med Port. 2010 Sep-Oct;23(5):941-4. Epub 2010 Oct 22.
The association between hepatitis C and B-cell non-Hodgkin lymphoma (NHL) has been suggested by several studies. We report the case of a 70 year-old patient with the diagnosis of chronic hepatitis C and splenic lymphoma with villous lymphocytes, who had undergone splenectomy and chemotherapy with fludarabine, with transient effectiveness. He was sent to our Hepatology Clinic for the treatment of hepatitis C, and Pegylated Interferon and Ribavirin were started. He had virological and hematological response (63% of villous lymphocytes in the peripheral blood at the beginning of therapy and 0% at the end). With the suspension of antiviral therapy, recurrence of HCV infection and reappearance of atypical lymphocytes (24%) were observed, and Pegylated Interferon was restarted, with good response. The relationship between viral and hematologic response (remission and relapse) supports the hypothesis that hepatitis C virus has an active role in the pathogenesis of splenic lymphoma with villous lymphocytes.
多项研究表明丙型肝炎与B细胞非霍奇金淋巴瘤（NHL）之间存在关联。我们报告一例70岁患者，诊断为慢性丙型肝炎合并绒毛状淋巴细胞性脾淋巴瘤，该患者接受了脾切除术及氟达拉滨化疗，疗效短暂。他因丙型肝炎治疗被转诊至我们的肝病诊所，开始使用聚乙二醇干扰素和利巴韦林治疗。他出现了病毒学和血液学反应（治疗开始时外周血中63%为绒毛状淋巴细胞，治疗结束时为0%）。随着抗病毒治疗的中断，观察到HCV感染复发及非典型淋巴细胞再次出现（24%），于是重新开始使用聚乙二醇干扰素，反应良好。病毒学反应与血液学反应（缓解和复发）之间的关系支持了丙型肝炎病毒在绒毛状淋巴细胞性脾淋巴瘤发病机制中起积极作用这一假说。
