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原发性骨淋巴瘤:一例病例报告及文献综述

Primary bone lymphoma: A case report and review of the literature.

作者信息

Zhou Hai-Yan, Gao Fang, Bu Bing, Fu Zheng, Sun Xu-Jie, Huang Cheng-Suo, Zhou Deng-Guang, Zhang Shu, Xiao Jun

机构信息

Internal Depatment of Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong 250117, P.R. China.

Positron Emission Tomography-Computed Tomography Center, Shandong Cancer Hospital and Institute, Jinan, Shandong 250117, P.R. China.

出版信息

Oncol Lett. 2014 Oct;8(4):1551-1556. doi: 10.3892/ol.2014.2327. Epub 2014 Jul 9.

Abstract

Primary lymphoma of the bone (PLB) primarily arising from the medullary cavity is an extremely rare entity, with only retrospective studies and sporadic cases reported in the literature. The current study presents one case of PLB treated with chemotherapy and radiotherapy, and a review of the literature to elucidate the optimal treatment of PLB. A 73-year-old female presented with pain in the left hip that had persisted for two months. Plain X-ray and magnetic resonance imaging of the left hip showed lytic areas involving the left innominatum. Technetium-99m radionuclide imaging showed increased tracer uptake in the ilium, acetabulum and ischium. An F-fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PET-CT) scan showed high FDG uptake. A fine-needle aspiration biopsy of the lesion was performed, and histopathological and immunohistochemical examination confirmed a diagnosis of B-cell lymphoma. The patient received radiation therapy followed by six cycles of CHOP regimen (1,000 mg cyclophosphamide, 80 mg epirubicine and 2 mg vincristine on day one, and 100 mg prednisone on days one to five, every three weeks) and achieved a complete response, as confirmed by FDG-PET-CT. At present, the patient is in a good condition. This case is noteworthy, as it is a well-documented case in which the patient received successful treatment. This case demonstrates that PLB has an improved prognosis compared with primary lymphoma of other sites; however, combined therapy may further improve the patient outcome.

摘要

原发性骨淋巴瘤(PLB)主要起源于骨髓腔,是一种极为罕见的疾病,文献中仅有回顾性研究及散发病例报道。本研究报告了一例接受化疗和放疗的PLB病例,并对文献进行综述以阐明PLB的最佳治疗方法。一名73岁女性因左髋部疼痛持续两个月前来就诊。左髋部的X线平片和磁共振成像显示左侧无名骨有溶骨性区域。锝-99m放射性核素成像显示髂骨、髋臼和坐骨的示踪剂摄取增加。氟-18氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描(FDG-PET-CT)显示FDG摄取增高。对病变进行了细针穿刺活检,组织病理学和免疫组织化学检查确诊为B细胞淋巴瘤。患者接受了放射治疗,随后进行了六个周期的CHOP方案(第1天给予环磷酰胺1000mg、表柔比星80mg和长春新碱2mg,第1至5天给予泼尼松100mg,每三周一次),FDG-PET-CT证实达到完全缓解。目前,患者状况良好。该病例值得关注,因为它是一例记录完整且患者接受成功治疗的病例。该病例表明,与其他部位的原发性淋巴瘤相比,PLB的预后有所改善;然而,联合治疗可能会进一步改善患者的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d1e/4156201/922912e1aca6/OL-08-04-1551-g00.jpg

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