Dedecjus Marek, Kędzierska Anna, Kozak Józef, Kordek Radzisław, Brzeziński Jan
Department of General, Oncological and Endocrine Surgery, Medical University in Łódź, Polish Mother's Memorial Hospital - Research Institute.
Pol Przegl Chir. 2012 Jul;84(7):363-6. doi: 10.2478/v10035-012-0061-9.
Primary extranodal sites of development of lymphoid neoplasms are rare and concern about 5% of patients with Hodgkin's lymphoma. Extranodal development is more common in non Hodgkin's lymphoma and may reach 33%. A 27-year-old woman was diagnosed by a cardiologist for a short breath. On the physical examination no other abnormalities were observed. Echocardiography, performed by cardiologist, revealed a large tumor, overlaying the right ventricle and compressing the pulmonary trunk. Chest X-ray, ultrasound and CT-scan confirmed diagnosis. In fine needle aspiration clear, lucid fluid was obtained. Scintygraphy of the neck and thorax showed accumulation of the marker in the properly placed but enlarged thyroid gland. Patient was qualified for surgical treatment - cervicotomy and sternothomy were performed. The histopatological exam of the tumor revealed Hodgkin's lymphoma of the mediastinum (classical subtype NS-1). Following the surgery, adjuvant therapy was instituted. After the treatment PET-CT-scan did not show any kind of non-physiological radiomarker's accumulation in the monitored regions of the body and in in three-years follow-up the patient shows no signs of recurrence.
淋巴肿瘤的原发性结外发病部位很少见,约占霍奇金淋巴瘤患者的5%。结外发病在非霍奇金淋巴瘤中更为常见,可达33%。一名27岁女性因呼吸急促被心脏病专家诊断。体格检查未发现其他异常。心脏病专家进行的超声心动图检查显示一个大肿瘤,覆盖右心室并压迫肺动脉干。胸部X光、超声和CT扫描确诊。细针穿刺获得清澈、透明的液体。颈部和胸部闪烁扫描显示标记物在位置正确但肿大的甲状腺中积聚。患者符合手术治疗条件——进行了颈部切开术和胸骨切开术。肿瘤的组织病理学检查显示为纵隔霍奇金淋巴瘤(经典NS-1亚型)。手术后开始辅助治疗。治疗后PET-CT扫描未显示身体监测区域有任何非生理性放射性标记物积聚,在三年随访中患者无复发迹象。