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金属对金属髋关节置换术后发生恶性淋巴瘤:一例病例报告及文献复习

Development of malignant lymphoma after metal-on-metal hip replacement: a case report and review of the literature.

作者信息

McCarthy C L, Uchihara Y, Vlychou M, Grammatopoulos G, Athanasou N A

机构信息

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Windmill Road, Oxford, OX3, 7HE, UK.

出版信息

Skeletal Radiol. 2017 Jun;46(6):831-836. doi: 10.1007/s00256-017-2612-y. Epub 2017 Mar 11.

Abstract

A number of previous studies have reported a potential risk of malignancy, particularly hematological malignancy, developing in patients receiving a metal-on-metal (MoM) hip replacement. We report a case of malignant lymphoma that arose in a patient who had an MoM hip arthroplasty complicated by development of a pseudotumour. The tumour was a B cell follicular lymphoma that involved lymph nodes and bone. Metal ions are known to have a genotoxic effect on lymphoid cells. Although epidemiological studies have not established that there is an increased risk of lymphoma associated with MoM implants, only a relatively short time period has elapsed since re-introduction of this type of implant and long-term follow-up of patients with MoM implants is indicated.

摘要

此前多项研究报告称,接受金属对金属(MoM)髋关节置换术的患者有发生恶性肿瘤的潜在风险,尤其是血液系统恶性肿瘤。我们报告一例恶性淋巴瘤病例,该患者接受MoM髋关节置换术后出现假瘤。肿瘤为B细胞滤泡性淋巴瘤,累及淋巴结和骨骼。已知金属离子对淋巴细胞具有遗传毒性作用。尽管流行病学研究尚未证实MoM植入物会增加淋巴瘤风险,但自重新引入此类植入物以来,时间间隔相对较短,因此有必要对接受MoM植入物的患者进行长期随访。

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