弥漫性大 B 细胞淋巴瘤表现为骶骨肿块和狼疮抗凝物。
Diffuse large cell lymphoma presenting as a sacral mass and lupus anticoagulant.
机构信息
Yale School of Medicine, New Haven, Connecticut 06510, USA.
出版信息
Yale J Biol Med. 2011 Dec;84(4):433-8.
A 67-year-old gentleman presented to Yale-New Haven Hospital (YNHH) for assessment of a supratherapeutic INR and sacral lesion. Hematologic workup revealed elevated ESR, PT, INR, PTT, and CRP, mixing studies that failed to correct, and a positive Russell Viper Venom Test (RVVT), which confirmed the presence of lupus anticoagulant (LA), a subtype of antiphospholipid syndrome (APA). Pathology of the patient's sacral lesion revealed diffuse large B-cell lymphoma. This case provides insight into the association between APA and lymphoid neoplasm. The patient's unique presentation is in marked contrast to other reports of APA and lymphoid malignancy, which are typically associated with elevated PTT, normal PT, minimal extranodal disease, and potential thrombotic complications. Further, treatment with Rituximab-CHOP chemotherapy led to excellent clinical response with tumor remission and normalization of PT and PTT.
一位 67 岁的男性绅士因治疗性 INR 升高和骶骨病变到耶鲁-纽黑文医院（YNHH）就诊。血液学检查显示 ESR、PT、INR、PTT 和 CRP 升高，混合研究未能纠正，以及阳性 Russell Viper Venom Test（RVVT），证实存在狼疮抗凝剂（LA），这是抗磷脂综合征（APA）的一个亚型。患者骶骨病变的病理学显示弥漫性大 B 细胞淋巴瘤。本病例提供了关于 APA 和淋巴肿瘤之间关联的见解。与其他 APA 和淋巴恶性肿瘤的报告相比，该患者的独特表现形成鲜明对比，后者通常与 PTT 升高、PT 正常、极少结外疾病和潜在血栓并发症相关。此外，用利妥昔单抗-CHOP 化疗治疗导致肿瘤缓解、PT 和 PTT 正常化，临床反应良好。
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