Hatsuse Mayumi, Fuchida Shin-ichi, Okano Akira, Murakami Satoshi, Haruyama Harue, Shimazaki Chihiro
Department of Hematology, Kyoto Social Insurance Hospital, Japan.
Rinsho Ketsueki. 2012 Dec;53(12):2018-20.
A 81-year-old man with a history of gastrointestinal stromal tumor (GIST) was admitted to our hospital due to increased level of LDH, and further testing revealed a serum sIL-2R level of 15,489 U/ml. CT scan demonstrated retroperitoneal fibrosis without lymphadenopathy, and bilateral hydronephrosis. He died of aspiration pneumonia, and post-mortem biopsy revealed diffuse infiltration of medium to large-sized lymphoid cells positive for CD20, CD79a, and BCL2 in the retroperitoneal space with mild fibrosis. These findings suggested a diagnosis of primary retroperitoneal diffuse large B-cell lymphoma (PRLBCL). PRLBCL is extremely rare, and should be included in the differential diagnosis in cases of retroperitoneal fibrosis.
一名81岁有胃肠道间质瘤(GIST)病史的男性因乳酸脱氢酶(LDH)水平升高入住我院,进一步检查发现血清可溶性白细胞介素-2受体(sIL-2R)水平为15489 U/ml。CT扫描显示腹膜后纤维化,无淋巴结肿大,双侧肾积水。他死于吸入性肺炎,尸检活检显示腹膜后间隙有中等至大尺寸淋巴细胞弥漫性浸润,CD20、CD79a和BCL2呈阳性,伴有轻度纤维化。这些发现提示诊断为原发性腹膜后弥漫性大B细胞淋巴瘤(PRLBCL)。PRLBCL极为罕见,在腹膜后纤维化病例的鉴别诊断中应予以考虑。