Kang K W, Lee J H, Choi J S, Lee S R, Park Y, Kim B S, Kim I
Department of Internal Medicine, Korea University School of Medicine, Seoul, Korea.
Transpl Infect Dis. 2014 Aug;16(4):676-80. doi: 10.1111/tid.12254. Epub 2014 Jun 26.
Compromised T-cell immunity persists for up to 1 year after autologous stem cell transplantation (ASCT), and patients treated with ASCT are more likely to develop atypical lymphoid hyperplasia that mimics tumor recurrence. Here, we present a case of cervical lymphadenitis due to cytomegalovirus (CMV) reactivation in a patient who had undergone ASCT for Burkitt lymphoma, which mimicked tumor recurrence on computed tomography and positron emission tomography-computed tomography 6 months after ASCT. This lesion was confined to the regional lymph nodes and was not accompanied by signs of systemic involvement, such as fever, splenomegaly, an elevated C-reactive protein level, or viremia. The localized CMV lymphadenitis resolved spontaneously without treatment after 6 months (12 months after ASCT) and the elevated CMV immunoglobulin-M titer normalized 6 months after resolution. Our experience with this case suggests that cautious follow-up without anti-CMV treatment should be considered in cases of post-ASCT localized CMV lymphadenitis without systemic involvement in patients with complete engraftment.
自体干细胞移植（ASCT）后，受损的T细胞免疫可持续长达1年，接受ASCT治疗的患者更有可能发生模仿肿瘤复发的非典型淋巴样增生。在此，我们报告1例接受ASCT治疗伯基特淋巴瘤的患者发生巨细胞病毒（CMV）再激活导致的颈部淋巴结炎，在ASCT后6个月的计算机断层扫描和正电子发射断层扫描-计算机断层扫描中，该病模仿了肿瘤复发。该病变局限于区域淋巴结，未伴有全身受累迹象，如发热、脾肿大、C反应蛋白水平升高或病毒血症。6个月后（ASCT后12个月），局部CMV淋巴结炎未经治疗自行消退，CMV免疫球蛋白M滴度在消退后6个月恢复正常。我们对该病例的经验表明，对于移植成功且无全身受累的ASCT后局部CMV淋巴结炎病例，应考虑在不进行抗CMV治疗的情况下进行谨慎随访。
