Sato I, Miura A, Yokomichi H, Suzuki C, Ichinohazama R
Department of Internal Medicine, National Sendai Hospital.
Rinsho Ketsueki. 1990 Jul;31(7):958-62.
We report a 47-year-old man diagnosed as angio-immunoblastic lymphadenopathy with dysproteinemia (AILD) with fibrosis of the bone marrow, lymph node, liver and spleen, and proliferation of epithelioid cells in lymph node. He was admitted to a hospital in May, 1980 because of general fatigue, cough, fever and systemic lymphadenopathy. The diagnosis of AILD was based on a biopsy of right cervical lymph node. His symptoms were improved but recurred with the addition of icterus and progressive pancytopenia with decrement of prednisolone. He was referred to our hospital in July, 1980 and his physical examination revealed generalized lymphadenopathy, icterus and hepatosplenomegaly. Hemogram showed pancytopenia, and needle biopsy of the bone marrow disclosed fibrosis. Sections from the lymph node showed AILD with proliferation of epithelioid cells. Administration of 60 mg/day of prednisolone improved the fever, lymphadenopathy and hepatosplenomegaly. However he died suddenly of acute respiratory failure on July 30. Autopsy showed fibrosis of bone marrow, lymph node, liver and spleen with infiltration of abnormal lymphocytes, and pulmonary aspergillosis.
我们报告一例47岁男性,诊断为血管免疫母细胞性淋巴结病伴蛋白异常血症(AILD),合并骨髓、淋巴结、肝脏和脾脏纤维化,以及淋巴结内上皮样细胞增生。他于1980年5月因全身乏力、咳嗽、发热和全身淋巴结肿大入院。AILD的诊断基于右侧颈部淋巴结活检。他的症状有所改善,但随着黄疸的出现以及泼尼松龙减量后全血细胞减少进行性加重而复发。1980年7月他转诊至我院,体格检查发现全身淋巴结肿大、黄疸和肝脾肿大。血常规显示全血细胞减少,骨髓穿刺活检显示纤维化。淋巴结切片显示AILD伴上皮样细胞增生。给予泼尼松龙60mg/天可改善发热、淋巴结肿大和肝脾肿大。然而,他于7月30日因急性呼吸衰竭突然死亡。尸检显示骨髓、淋巴结、肝脏和脾脏纤维化,伴有异常淋巴细胞浸润,以及肺部曲霉菌病。