Cortes Margarida, Fernandes Samuel, Teixeira Vitor, Freitas Luis Carlos
Medicina Interna, Hospital de Santa Maria, Portugal.
Gastrenterologia e Hepatologia, Hospital Santa Maria, Portugal.
Rev Esp Enferm Dig. 2016 Sep;108(9):576.
A 68-year-old female patient with Sjögren syndrome was admitted with asthenia, anorexia and weight loss. On the third day of admission, she developed severe hematemesis. Urgent upper gastrointestinal endoscopy (UGE) showed multiple gastric and duodenal ulcers, some with active bleeding requiring endoscopic therapy. The anatomopathologic examination was compatible with gastric and duodenal infiltration by a diffuse CD20+ large B cell lymphoma with germinal center B cell-like morphology. And the patient was referred for chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone. Although seldom observed, the risk of lymphoma in Sjögren syndrome is up to 44 times higher than the general population and rises 7 years after diagnosis. We present a brief case report with interesting iconography.
一名68岁的干燥综合征女性患者因乏力、厌食和体重减轻入院。入院第三天，她出现严重呕血。紧急上消化道内镜检查（UGE）显示胃和十二指肠多发溃疡，部分伴有活动性出血，需要内镜治疗。解剖病理学检查结果与弥漫性CD20+大B细胞淋巴瘤伴生发中心B细胞样形态浸润胃和十二指肠相符。该患者被转诊接受利妥昔单抗、环磷酰胺、阿霉素、长春新碱和泼尼松龙化疗。干燥综合征患者发生淋巴瘤的风险虽然很少见，但比普通人群高44倍，且在诊断后7年上升。我们展示一份伴有有趣影像学表现的简短病例报告。
