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一名被诊断为非霍奇金淋巴瘤的患者在化疗后发生肠穿孔:病例报告及文献复习

Intestinal perforation that developed after chemotherapy in a patient diagnosed with non-Hodgkin lymphoma: A case report and review of literature.

作者信息

Tatar Cihad, Yavas Mazlum, Akkus Onder, Tapkan Bahaeddin, Batikan Oguz Kagan, Bayrak Savas, Arikan Soykan

机构信息

Istanbul Training and Research Hospital, Department of General Surgery, Istanbul, Turkey.

出版信息

Int J Surg Case Rep. 2017;39:321-323. doi: 10.1016/j.ijscr.2017.08.058. Epub 2017 Sep 2.

Abstract

INTRODUCTION

Non-Hodgkin Lymphomas (NHL) appear with the malign transformation of mature lymphocytes. Intestinal perforations are one of the most well-known complications of NHLs. In this review, a 29-year-old male patient who was diagnosed with NHL with gastrointestinal involvement that developed intestinal perforation after chemotherapy is presented.

PRESENTATION OF CASE

A 29-year-old male patient who received systemic chemotherapy in another healthcare center due to Major B-Cell Lymphoma was examined because he had stomachache after the treatment. The patient was urgently taken to operation. In the exploration, there were partly mass lesions in all small intestine segments. It was determined that one of the lesion was perforated. Small intestine resection was applied. The pathology report on resection material was reported as High Grade Major B-Cell Lymphoma.

DISCUSSION

In the treatment of Lymphoma with intestinal B-Cells, there is no consensus because this disease is rarely observed. Perforation may appear as a complication of the chemotherapy. Depending on the steroids given to the patient, perforation may develop, and the clinical symptoms may be masked.

CONCLUSION

It must be born in mind that there may be intestinal involvement in patients diagnosed with NHL, and intestinal perforation may develop due to chemotherapy.

摘要

引言

非霍奇金淋巴瘤(NHL)表现为成熟淋巴细胞的恶性转化。肠穿孔是NHL最常见的并发症之一。在本综述中,介绍了一名29岁男性患者,他被诊断为伴有胃肠道受累的NHL,化疗后发生了肠穿孔。

病例介绍

一名29岁男性患者因原发性B细胞淋巴瘤在另一家医疗中心接受全身化疗,因治疗后出现腹痛前来就诊。患者被紧急送往手术室。探查发现所有小肠段均有部分肿块病变。确定其中一个病变已穿孔。进行了小肠切除术。切除材料的病理报告为高级别原发性B细胞淋巴瘤。

讨论

在肠道B细胞淋巴瘤的治疗中,由于这种疾病很少见,因此没有达成共识。穿孔可能是化疗的并发症。根据给予患者的类固醇药物,可能会发生穿孔,并且临床症状可能被掩盖。

结论

必须牢记,被诊断为NHL的患者可能存在肠道受累,并且化疗可能导致肠穿孔。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1836/5597875/4f7a0c764418/gr1.jpg

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