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源自胃肠道的髓系肉瘤:一例报告并文献复习

Myeloid sarcoma derived from the gastrointestinal tract: A case report and review of the literature.

作者信息

Yu Teng, Xu Genbo, Xu Xiaohua, Yang Jing, Ding Luyin

机构信息

Department of Hematology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China.

出版信息

Oncol Lett. 2016 Jun;11(6):4155-4159. doi: 10.3892/ol.2016.4517. Epub 2016 May 4.

Abstract

Myeloid sarcoma is a type of malignant neoplasm composed of myeloblasts that locates extramedullary. The present study reports the case of a 31-year-old female who presented with upper abdominal pain, melena, vomiting and jaundice. The abdominal computed tomography revealed a mass in gastric antrum area and possible infiltration of the duodenum, gallbladder and head of the pancreas, with possible retroperitoneal lymph node metastasis. The tumor grew quickly and led to serious obstructive jaundice. New masses developed in the bilateral orbits and left breast within 2 months of admission. The pathological results of the gastroscopic biopsy and the fine-needle biopsy of the breast revealed myeloid sarcoma. Transhepatic cholangial drainage, radiotherapy and chemotherapy were administered, but the disease reoccurred and became resistant to chemotherapy, so salvage allogenetic peripheral blood stem cell transplantation was performed. The disease relapsed at 5 months post-transplantation, and chemotherapy and donor lymphocytes transfusions were then administered. The patient declined further treatment and succumbed to disease on May 19, 2015. The present study could improve the understanding of myeloid sarcoma and provide a reference for standardized and individualized treatments for this disease.

摘要

髓系肉瘤是一种由髓母细胞组成的恶性肿瘤,位于髓外。本研究报告了一例31岁女性患者,其表现为上腹部疼痛、黑便、呕吐和黄疸。腹部计算机断层扫描显示胃窦区有肿块,十二指肠、胆囊和胰头可能有浸润,可能有腹膜后淋巴结转移。肿瘤生长迅速,导致严重的梗阻性黄疸。入院后2个月内双侧眼眶和左乳出现新肿块。胃镜活检和乳腺细针穿刺活检的病理结果显示为髓系肉瘤。进行了经皮肝穿刺胆管引流、放疗和化疗,但疾病复发且对化疗耐药,因此进行了挽救性异基因外周血干细胞移植。移植后5个月疾病复发,随后进行了化疗和供体淋巴细胞输注。患者拒绝进一步治疗,于2015年5月19日死于该疾病。本研究可以提高对髓系肉瘤的认识,并为该疾病的规范化和个体化治疗提供参考。

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