Ruan Gui-ren, Wang Huan-ling, Ge Ying, Shi Xiao-chun, Guo Fu-ping, Zhong Ding-rong, Zhou Dao-bin, Li Tai-sheng
Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Nei Ke Za Zhi. 2012 Mar;51(3):184-7.
To analyze the clinical characteristics of AIDS-related non-Hodgkin lymphoma (ARL) and review relative literature for the diagnosis and treatment of ARL.
The clinical data of ARL patients admitted to Peking Union Medical College Hospital from April 2009 to April 2011 were retrospectively analyzed.
Five male ARL patients aged 32 to 65 years old were included in this retrospective study. Among them, two patients were found to be HIV-positive for the first time, three were on regular highly active anti-retroviral therapy (HAART) for 7 - 8 months before the emergence of lymphoma-related symptoms. CD(4)(+) T cell count was (69 - 232) × 10(6)/L at presentation. Two patients firstly presented with sore throat and throat ulcer, one with cervical nodules, one with pelvic mass, one with fever and edema in right thigh. Through pathological analysis, four patients had B cell-originated lymphoma, with one Burkitt lymphoma and three diffuse large B cell lymphomas; one patient had T-cell lymphoma. Four patients were treated with chemotherapy, with one complete remission, one relapse, one non-response, and one death. One patient had radiotherapy only and had progressed disease. Bone marrow suppression and gastrointestinal disturbance were the main adverse effects of chemotherapy.
Lymphoma should be considered in any HIV-infected patients presented with unexplainable adenopathy, recurrent sore throat or throat ulcer, or fever of unknown origin. Biopsy should be rigorously carried out. Appropriate chemotherapy, together with HAART, may improve the prognosis greatly.
分析艾滋病相关非霍奇金淋巴瘤(ARL)的临床特征,并复习相关文献以探讨ARL的诊断和治疗。
回顾性分析2009年4月至2011年4月在北京协和医院住院的ARL患者的临床资料。
本回顾性研究纳入5例年龄在32至65岁的男性ARL患者。其中,2例患者首次被发现HIV阳性,3例在出现淋巴瘤相关症状前接受常规高效抗逆转录病毒治疗(HAART)7至8个月。就诊时CD4(+) T细胞计数为(69 - 232)×10(6)/L。2例患者首发症状为咽痛和口腔溃疡,1例为颈部结节,1例为盆腔肿块,1例为发热伴右大腿水肿。经病理分析,4例患者为B细胞起源淋巴瘤,其中1例为伯基特淋巴瘤,3例为弥漫大B细胞淋巴瘤;1例患者为T细胞淋巴瘤。4例患者接受化疗,1例完全缓解,1例复发,1例无反应,1例死亡。1例患者仅接受放疗,病情进展。化疗的主要不良反应为骨髓抑制和胃肠道紊乱。
任何出现不明原因淋巴结病、反复咽痛或口腔溃疡、或不明原因发热的HIV感染患者均应考虑淋巴瘤的可能。应严格进行活检。适当的化疗联合HAART可能会大大改善预后。