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胃肠道浆母细胞淋巴瘤:一种预后不佳的罕见实体。

Plasmablastic lymphoma of the gastrointestinal tract: A rare entity with a dismal prognosis.

作者信息

Komaranchath A S, Haleshappa R A, Kuntegowdenahalli L C, Kumar R V, Dasappa L, Babu G

机构信息

Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.

Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.

出版信息

Indian J Cancer. 2016 Oct-Dec;53(4):529-533. doi: 10.4103/0019-509X.204756.

Abstract

INTRODUCTION

Plasmablastic lymphoma (PBL) is a rare and aggressive type of mature B-cell lymphoma, which is usually associated with HIV infection. The most common site of PBL is the oral cavity. Involvement of the gastrointestinal (GI) tract is rare, and literature is limited to few case reports and case series.

AIMS

To retrospectively analyze the presentation, clinical findings, and outcome of patients presenting to our institute with a diagnosis of PBL involving the GI tract.

MATERIALS AND METHODS

A retrospective observational study was conducted at our institute from February 2008 to January 2015 on consecutive patients presenting with PBL involving the GI tract. The data were compared to various case reports and series published in peer-reviewed journals.

RESULTS

There were four patients diagnosed with PBL of the GI tract; three male and one female. The location of involvement was in the stomach, ileocecal junction, ascending colon, and rectum. Only one patient was HIV-positive and was on combination antiretroviral therapy since 2 years. Among the three immunocompetent patients, only one survived with therapy; however, the patient relapsed within 6 months of completion of treatment.

CONCLUSION

PBL was seen to have a uniformly aggressive clinical course with poor outcomes even with optimal treatment. The prognosis of immunocompetent patients appears to be worse than that of HIV-AIDS patients. Although the most common histologies seen with GI lymphomas are mucosa-associated lymphoid tissue type lymphomas or diffuse large B-cell lymphoma, rarer and more aggressive histologies like PBL need to be kept in mind.

摘要

引言

浆母细胞淋巴瘤(PBL)是一种罕见且侵袭性强的成熟B细胞淋巴瘤,通常与HIV感染相关。PBL最常见的部位是口腔。胃肠道受累罕见,相关文献仅限于少数病例报告和病例系列。

目的

回顾性分析我院诊断为胃肠道受累的PBL患者的临床表现、临床发现及预后。

材料与方法

2008年2月至2015年1月在我院对连续出现胃肠道受累的PBL患者进行了一项回顾性观察研究。将数据与同行评审期刊上发表的各种病例报告和系列进行比较。

结果

有4例患者被诊断为胃肠道PBL;3例男性,1例女性。受累部位为胃、回盲部、升结肠和直肠。仅1例患者HIV阳性,且已接受联合抗逆转录病毒治疗2年。在3例免疫功能正常的患者中,仅1例经治疗存活;然而,该患者在完成治疗后6个月内复发。

结论

即使经过最佳治疗,PBL的临床病程仍具有一致的侵袭性,预后较差。免疫功能正常患者的预后似乎比HIV/AIDS患者更差。虽然胃肠道淋巴瘤最常见的组织学类型是黏膜相关淋巴组织型淋巴瘤或弥漫性大B细胞淋巴瘤,但像PBL这样更罕见且侵袭性更强的组织学类型也需要予以关注。

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