黏膜相关淋巴组织淋巴瘤患者的抗利尿激素分泌异常综合征

Shimizu Naomi, Tanaka Sho, Watanabe Yasuhiro, Tokuyama Wataru, Hiruta Nobuyuki, Ohwada Chikako, Sakaida Emiko, Nakaseko Chiaki, Tatsuno Ichiro

Center for Diabetes, Metabolism and Endocrinology, Toho University Sakura Medical Center, Japan.

Division of Pathology, Toho University Sakura Medical Center, Japan.

Intern Med. 2017 Dec 1;56(23):3225-3229. doi: 10.2169/internalmedicine.9048-17. Epub 2017 Oct 11.

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) may develop in association with several malignancies. However, as an immunohistochemical analysis is not performed in the majority cases, its true cause is often uncertain. We herein report a case of SIADH following chemotherapy due to tumor-derived ADH production in a patient with mucosa-associated lymphoid tissue (MALT) lymphoma. A retrospective immunohistochemical analysis demonstrated ADH expression by lymphoma cells. These findings highlight the importance of using an immunohistochemical analysis to determine ADH production by tumor cells in patients with SIADH. Such analyses play an important role in elucidating the pathogenesis of SIADH and determining the most appropriate treatment.

抗利尿激素分泌不当综合征（SIADH）可能与多种恶性肿瘤相关。然而，由于大多数病例未进行免疫组化分析，其真正病因往往不明。我们在此报告一例黏膜相关淋巴组织（MALT）淋巴瘤患者化疗后因肿瘤产生抗利尿激素而发生SIADH的病例。回顾性免疫组化分析显示淋巴瘤细胞表达抗利尿激素。这些发现凸显了利用免疫组化分析来确定SIADH患者肿瘤细胞产生抗利尿激素的重要性。此类分析在阐明SIADH的发病机制及确定最合适的治疗方法方面发挥着重要作用。