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晚期慢性淋巴细胞白血病合并严重支气管肺炎:一例尸检病例报告

Advanced chronic lymphoid leukemia with severe bronchopneumonia: an Autopsy Case Report.

作者信息

Amaral Felipe Gomes Campos, Lima Luiz Guilherme Cernaglia Aureliano, Hatanaka Veruska Menegatti Anastacio, Siqueira Sheila Aparecida Coelho, Duarte-Neto Amaro Nunes

机构信息

Anatomic Pathology Department - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil .

Instituto do Câncer do Estado de São Paulo - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil .

出版信息

Autops Case Rep. 2016 Mar 30;6(1):11-20. doi: 10.4322/acr.2016.022. eCollection 2016 Jan-Mar.

Abstract

Chronic lymphocytic leukemia (CLL) is a lymphoid neoplasia with the B immunophenotype, which corresponds to the leukemic form of lymphocytic lymphoma. This entity is characterized, in most cases, by immunosuppression due to impaired function of immune cells, hypogammaglobulinemia, bone marrow infiltration, and immune dysfunction due to the neoplasia and the chemotherapy, when prescribed. We describe the case of a 63-year-old woman with a previous diagnosis of advanced CLL, refractory to treatment, who presented respiratory failure at the emergency department and died soon after hospital admission. The autopsy examination showed a large retroperitoneal mass compressing large vessels and abdominal and pelvic organs; generalized lymphadenopathy; and liver, spleen, bone marrow, heart and kidney infiltration. A Gram-negative bacilli bronchopneumonia with diffuse alveolar damage was detected, which was likely to be the immediate cause of death.

摘要

慢性淋巴细胞白血病(CLL)是一种具有B免疫表型的淋巴样肿瘤,相当于淋巴细胞淋巴瘤的白血病形式。在大多数情况下,该实体的特征是由于免疫细胞功能受损导致免疫抑制、低丙种球蛋白血症、骨髓浸润以及肿瘤和化疗(如使用时)引起的免疫功能障碍。我们描述了一名63岁女性的病例,她先前被诊断为晚期CLL,对治疗无效,在急诊科出现呼吸衰竭,入院后不久死亡。尸检显示腹膜后有一个巨大肿块,压迫大血管以及腹部和盆腔器官;全身淋巴结肿大;肝脏、脾脏、骨髓、心脏和肾脏有浸润。检测到革兰氏阴性杆菌性支气管肺炎伴弥漫性肺泡损伤,这可能是直接死因。

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