Arora Nivedita, Gupta Arjun, Sadeghi Navid
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Parkland Health and Hospital System, Dallas, Texas, USA.
BMJ Case Rep. 2017 Oct 9;2017:bcr-2017-222063. doi: 10.1136/bcr-2017-222063.
Plasmablastic lymphoma (PBL) is an aggressive form of non-Hodgkin's lymphoma (NHL) classically seen in patients infected with the human immunodeficiency virus, but can also be seen in other immunocompromised states such as transplant recipients, autoimmune diseases and the elderly. PBL is generally associated with a poor prognosis despite chemotherapy. There is evidence supporting the use of bortezomib in combination with standard chemotherapy to achieve durable responses in patients with PBL. We describe a patient with acquired immunodeficiency syndrome who presented with rectal pain and bright red blood per rectum. He was diagnosed with stage IVA PBL with anorectal, nodal, calvarial and hepatic involvement. Along with highly active antiretroviral therapy, he was treated with six cycles of dose adjusted etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA-EPOCH) plus bortezomib resulting in durable complete remission 30 months after diagnosis.
浆母细胞淋巴瘤（PBL）是一种侵袭性非霍奇金淋巴瘤（NHL），典型地见于感染人类免疫缺陷病毒的患者，但也可见于其他免疫功能低下状态，如移植受者、自身免疫性疾病患者及老年人。尽管进行了化疗，PBL的预后通常较差。有证据支持使用硼替佐米联合标准化疗，以使PBL患者获得持久缓解。我们描述了一名获得性免疫缺陷综合征患者，其表现为直肠疼痛和直肠鲜红色血便。他被诊断为IVA期PBL，累及肛管直肠、淋巴结、颅骨和肝脏。除了高效抗逆转录病毒治疗外，他接受了六个周期的剂量调整依托泊苷、泼尼松、长春新碱、环磷酰胺和多柔比星（DA-EPOCH）加硼替佐米治疗，诊断后30个月实现了持久的完全缓解。
