Inoue T, Yamane T, Sasaki A, Sannomiya Y, Im T, Tatsumi N, Okuda K
Rinsho Ketsueki. 1989 Mar;30(3):338-42.
A 58-year-old male was admitted to Osaka City University Hospital because of diplopia in May, 1987. Hematological examinations revealed abnormal blastoid cells in his peripheral blood and bone marrow. We found many mitochondria and polysomes in the cytoplasm of the blastoid cells by the electron microscopy. Moreover, left axillary lymph node biopsy specimen disclosed the typical "starry sky" pattern. The blastoid cells in the bone marrow had chromosomal abnormality; 47XY, 8q-, 14q+, 22q-, +mar. Therefore, the diagnosis of Burkitt's lymphoma (leukemic change) was performed. He was treated with chemotherapy, but the blastoid cells resisted many anticancer agents and he died in September 30. On admission left ocular motor disturbance was revealed. Generally, it was reported that meningitis with CNS involvement of lymphoma is accompanied by cranial nerves palsy. However in this case lymphoma cells was not found in the cerebrospinal fluid. The cause of ocular motor disturbance was the adhesion to the medial rectus muscle and compression to the ocular motor nerves of the lymphoma mass.
1987年5月，一名58岁男性因复视入住大阪市立大学医院。血液学检查发现其外周血和骨髓中有异常的原始细胞。通过电子显微镜，我们在原始细胞的细胞质中发现了许多线粒体和多核糖体。此外，左腋窝淋巴结活检标本显示出典型的“满天星”模式。骨髓中的原始细胞存在染色体异常；47XY，8q-，14q+，22q-，+mar。因此，诊断为伯基特淋巴瘤（白血病样改变）。他接受了化疗，但原始细胞对多种抗癌药物耐药，于9月30日死亡。入院时发现左眼运动障碍。一般来说，据报道淋巴瘤累及中枢神经系统的脑膜炎伴有颅神经麻痹。然而，在该病例中脑脊液中未发现淋巴瘤细胞。眼运动障碍的原因是淋巴瘤肿块与内直肌粘连并压迫眼运动神经。
