Alkhasawneh Ahmad, Mubeen Aysha, Gopinath Arun
Department of Pathology and Laboratory Medicine, University of Florida College of Medicine - Jacksonville, 655 West 8th Street, Box C-506, Jacksonville, FL, 32209-6511, USA.
Forensic Sci Med Pathol. 2018 Sep;14(3):327-331. doi: 10.1007/s12024-018-9996-4. Epub 2018 Jun 23.
Lymphoproliferative disorders cause significant morbidity and mortality, either related to the disease itself or therapy complications. Some cases of lymphoma may have vague clinical presentation, especially in the absence of lymphadenopathy, and a clinical work up may not be conclusive. Our study focuses on autopsy cases of lymphoma patients, emphasizing clinically unsuspected cases. Autopsy records from the last 20 years at our institution were searched, and the clinical parameters were recorded. Fifteen cases of lymphoma were identified, and 5 cases were diagnosed at the time of autopsy. Most B-cell lymphoma cases were mainly nodal disease, while T-cell lymphoma cases had widespread extra-nodal disease. Most deaths in B-cell lymphoma are due to infection/therapy induced immunosuppression, whereas T-cell lymphoma deaths are due to organ infiltration by lymphoma. Postmortem examination may reveal clinically unsuspected lymphoma, especially in rapidly deteriorating patients with vague presentation such as skin rash, bowel obstruction/bleeding or pacemaker malfunction.
淋巴增生性疾病会导致显著的发病率和死亡率，这与疾病本身或治疗并发症有关。某些淋巴瘤病例可能临床表现不明确，尤其是在没有淋巴结病的情况下，临床检查可能无法得出结论。我们的研究聚焦于淋巴瘤患者的尸检病例，重点关注临床未怀疑的病例。检索了我们机构过去20年的尸检记录，并记录了临床参数。共识别出15例淋巴瘤病例，其中5例是在尸检时确诊的。大多数B细胞淋巴瘤病例主要为淋巴结疾病，而T细胞淋巴瘤病例有广泛的结外疾病。B细胞淋巴瘤的大多数死亡是由于感染/治疗引起的免疫抑制，而T细胞淋巴瘤的死亡是由于淋巴瘤对器官的浸润。尸检可能会发现临床未怀疑的淋巴瘤，尤其是在病情迅速恶化、表现不明确的患者中，如皮疹、肠梗阻/出血或起搏器故障。
