Khattak Taif, Ali Shah Syed Hashim, Khan Waqas, Raza Syed Shahmeer, Ahmad Uzair, Ullah Farhan
Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan.
J Ayub Med Coll Abbottabad. 2017 Oct-Dec;29(4):684-685.
Hodgkin's lymphoma. A 25 years old lady, 34 weeks primigravida was referred from the Emergency Department to the Medical Unit Khyber Teaching Hospital-MTI, Peshawar with four weeks of fever, progressive jaundice, pruritus, night sweats and weight loss. LFTs showed cholestatic picture, ERCP showed scanty intrahepatic giving beading and autumn tree appearance typical of sclerosing cholangitis. CBD was normal. Doppler U/S of hepatic and portal vein reported normal. She was started on steroids, ursodeoxycholic acid and antibiotics 3rd generation cephalosporins to which she did not respond well. This prompted a Liver biopsy which showed Hodgkin's disease having mixed cellularity. She was shifted to specialized oncology unit for further management where she died of irreversible liver damage. This is a rare case of secondary sclerosing cholangitis in Hodgkin's lymphoma of liver and the first case reported to our Hospital.
霍奇金淋巴瘤。一名25岁初产妇，孕34周，从急诊科转诊至白沙瓦开伯尔教学医院医学科（MTI），有四周发热、进行性黄疸、瘙痒、盗汗及体重减轻症状。肝功能检查显示胆汁淤积表现，内镜逆行胰胆管造影（ERCP）显示肝内胆管稀少，呈典型的硬化性胆管炎的串珠样和秋树外观。胆总管正常。肝脏和门静脉的多普勒超声检查报告正常。给予她类固醇、熊去氧胆酸和第三代头孢菌素类抗生素治疗，但效果不佳。这促使进行肝活检，结果显示为混合细胞型霍奇金病。她被转至专门的肿瘤科进一步治疗，最终死于不可逆转的肝损伤。这是肝霍奇金淋巴瘤继发硬化性胆管炎的罕见病例，也是我院报告的首例。
