Usuda Daisuke, Arahata Masahisa, Takeshima Kento, Sangen Ryusho, Takamura Akiteru, Kawai Yasuhiro, Kasamaki Yuji, Iinuma Yoshitsugu, Kanda Tsugiyasu
Department of Infectious Diseases, Kanazawa Medical University, Uchinada, Japan.
Department of Community Medicine, Kanazawa Medical University Himi Municipal Hospital, Himi, Japan.
Case Rep Oncol. 2017 Nov 16;10(3):1013-1022. doi: 10.1159/000484042. eCollection 2017 Sep-Dec.
A 93-year-old female was transferred to the emergency ward of our hospital due to disturbance of consciousness and hypotension. Computed tomography showed bilateral pleural and pericardial effusion without evidence of tumor masses or lymphadenopathy. Cytodiagnosis of pleural effusion revealed proliferation of atypical lymphoid-like cells with pan-B surface markers. We suspected primary effusion lymphoma-like lymphoma; however, the monoclonality of these cells was not confirmed. Cytodiagnosis of bone marrow revealed lymphoma cells with monoclonal B-cell markers. These findings prompted a diagnosis of diffuse large B-cell lymphoma with bone marrow invasion. In the case of pericardial or pleural effusion, clinicians should consider carefully both hematological malignancy and its classification.
一名93岁女性因意识障碍和低血压被转入我院急诊科。计算机断层扫描显示双侧胸腔和心包积液，未发现肿瘤肿块或淋巴结病迹象。胸腔积液的细胞诊断显示具有全B表面标志物的非典型淋巴样细胞增殖。我们怀疑是原发性渗出性淋巴瘤样淋巴瘤；然而，这些细胞的单克隆性未得到证实。骨髓细胞诊断显示具有单克隆B细胞标志物的淋巴瘤细胞。这些发现提示诊断为弥漫性大B细胞淋巴瘤伴骨髓侵犯。对于心包或胸腔积液病例，临床医生应仔细考虑血液系统恶性肿瘤及其分类。
