Department of Internal Medicine, Hemato-oncology, Chosun University Hospital, 588 Seoseok-dong Dong-gu, Gwangju, 501-717, Republic of Korea.
Int J Hematol. 2011 Mar;93(3):394-399. doi: 10.1007/s12185-011-0788-9. Epub 2011 Feb 24.
Tumor lysis syndrome is a well-described, serious complication of chemotherapy administered to treat malignancies. However, a very rare event resulting in the spontaneous necrosis of a tumor prior to therapy can also occur, which is termed spontaneous tumor lysis syndrome (STLS). We present a case of a 27-year-old male who presented to the hospital with epistaxis, dyspnea, and cervical lymphadenopathy. Laboratory findings included progressive pancytopenia, hyperuricemia, and acute renal failure. Bone marrow biopsy showed a T cell lymphoid neoplasm that had entirely infiltrated the marrow stroma. The patient was diagnosed with STLS in the setting of a T cell lymphoma with bone marrow infiltration. The patient was immediately treated with a blood transfusion and hemodialysis. After this urgent treatment, the patient's pancytopenia resolved and the lymphadenopathy disappeared spontaneously. One month post-treatment, the patient's cervical lymphadenopathy recurred and peripheral T cell lymphoma, not otherwise specified, was confirmed. STLS has previously been reported, however, most known cases of STLS did not show a decreased tumor burden resulting from massive tumor cell death. We present a rare case of STLS with resolution of pancytopenia and disappearance of lymphadenopathy in a patient with peripheral T cell lymphoma not otherwise specified.
肿瘤溶解综合征是一种常见的、严重的化疗并发症，用于治疗恶性肿瘤。然而，在治疗前，肿瘤也可能会发生一种非常罕见的自发坏死事件，称为自发性肿瘤溶解综合征（STLS）。我们报告了一例 27 岁男性患者，因鼻出血、呼吸困难和颈部淋巴结肿大而就诊。实验室检查发现全血细胞减少、高尿酸血症和急性肾衰竭。骨髓活检显示 T 细胞淋巴样肿瘤已完全浸润骨髓基质。该患者被诊断为 T 细胞淋巴瘤伴骨髓浸润的 STLS。患者立即接受输血和血液透析治疗。经过紧急治疗后，患者的全血细胞减少症得到缓解，淋巴结肿大也自发消失。治疗后 1 个月，患者出现颈部淋巴结肿大复发，并确诊为非特指性外周 T 细胞淋巴瘤。STLS 此前已有报道，但大多数已知的 STLS 病例并未显示出由于大量肿瘤细胞死亡导致肿瘤负荷降低。我们报告了一例罕见的 STLS 病例，在外周 T 细胞淋巴瘤未分类的患者中，全血细胞减少症和淋巴结肿大均得到缓解。
