Pereira Rui, Carvalho Joana, Patrício Catarina, Farinha Pedro
Department of Internal Medicine, Hospital de Santo António dos Capuchos, Lisboa, Portugal.
Department of Anatomic Pathology, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
BMJ Case Rep. 2014 Oct 13;2014:bcr2014204533. doi: 10.1136/bcr-2014-204533.
Primary effusion lymphoma (PEL) is one of the least common of the AIDS-related lymphomas, accounting for less than 1-4% of cases. Clinical manifestations depend on the extent and distribution of disease and, as in the majority of patients no detectable mass lesion is found, symptoms are related to fluid accumulation, dyspnoea (pleural or pericardial effusions), abdominal distension (ascites) or joint swelling. The median survival after diagnosis, even with aggressive chemotherapy, remains poor and remissions are often of short duration. We present the case of a 31-year-old man with AIDS and diagnosis of PEL, in whom sustained and complete remission of the tumour was achieved with adjunctive ganciclovir therapy. Since the disease is so uncommon, there is a paucity of data to guide the treatment of these patients; ganciclovir might be a potential antiviral therapeutic option, as demonstrated by the 2-year remission achieved in our patient.
原发性渗出性淋巴瘤（PEL）是与艾滋病相关的淋巴瘤中最不常见的类型之一，占病例不到1 - 4%。临床表现取决于疾病的范围和分布，由于大多数患者未发现可检测到的肿块病变，症状与液体蓄积、呼吸困难（胸腔或心包积液）、腹胀（腹水）或关节肿胀有关。即使进行积极化疗，诊断后的中位生存期仍然很差，缓解期通常很短。我们报告一例31岁患有艾滋病且诊断为PEL的男性患者，其通过辅助更昔洛韦治疗实现了肿瘤的持续完全缓解。由于这种疾病非常罕见，缺乏指导这些患者治疗的数据；正如我们患者实现的2年缓解所证明的，更昔洛韦可能是一种潜在的抗病毒治疗选择。
