一名晚期艾滋病患者的原发性肺淋巴瘤。
Primary pulmonary lymphoma in a patient with advanced AIDS.
作者信息
Shahani Lokesh, McKenna Megan
机构信息
Department of Infectious Disease, Baylor College of Medicine, Houston, Texas, USA.
Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.
出版信息
BMJ Case Rep. 2014 Dec 19;2014:bcr2013203265. doi: 10.1136/bcr-2013-203265.
Non-Hodgkin's lymphoma (NHL) is an AIDS defining lesion and risk of NHL most likely correlates with the degree of immunosuppression from HIV. Risk of NHL is highest among patients with CD4 count <50 cells/mL. Primary pulmonary lymphoma (PPL) is an infrequent cause of AIDS-related lymphoma. The authors report a patient with advanced AIDS presenting with recurrent fever and pulmonary nodule seen on the CT scan. The patient remained febrile despite being on broad spectrum antibiotics with no clear source of infection. The patient underwent a bronchoscopy with biopsy of the pulmonary lesion which was most consistent with diffuse large B-cell lymphoma. The patient was started on dose-adjusted etoposide, vincristine, doxorubicin, cyclophosphamide and prednisone (EPOCH) and was noted to be afebrile and a repeat CT scan few weeks later showed resolution of her pulmonary nodule. This case highlights the importance of considering NHL in patients with advanced AIDS presenting with pulmonary nodule and fever.
非霍奇金淋巴瘤（NHL）是一种艾滋病定义性病变，NHL的风险很可能与HIV导致的免疫抑制程度相关。CD4细胞计数<50个细胞/毫升的患者患NHL的风险最高。原发性肺淋巴瘤（PPL）是艾滋病相关淋巴瘤的罕见病因。作者报告了一名晚期艾滋病患者，出现反复发热，CT扫描显示肺部有结节。尽管使用了广谱抗生素，但患者仍持续发热，且无明确感染源。患者接受了支气管镜检查并对肺部病变进行活检，结果最符合弥漫性大B细胞淋巴瘤。患者开始接受剂量调整的依托泊苷、长春新碱、阿霉素、环磷酰胺和泼尼松（EPOCH）治疗，随后体温恢复正常，几周后复查CT扫描显示肺部结节消失。该病例强调了对于出现肺部结节和发热的晚期艾滋病患者考虑NHL的重要性。
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