与肾细胞癌相关的T细胞大颗粒淋巴细胞白血病：一例报告。
T-cell large granular lymphocytic leukemia associated with renal cell carcinoma: A case report.
作者信息
Qiu Zhi-Yuan, Wang Yan, Zhang Jun, Zhang Zhao, Fan Lei, Wang Rong, Wu Yu-Jie, Zhang Ye-Qing, Xu Wei, Li Jian-Yong
机构信息
Department of Oncology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang.
Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
出版信息
Medicine (Baltimore). 2018 Nov;97(44):e13064. doi: 10.1097/MD.0000000000013064.
RATIONALE
T-cell large granular lymphocytic leukemia (T-LGLL) is a rare lymphoproliferative neoplasm of cytotoxic T cells and renal cell carcinoma (RCC) is the most common form of kidney cancer, but T-LGLL associated with RCC has never been reported.
PATIENT CONCERNS
A 58-year-old Chinese male presented with general fatigue and intermittent-remittent fever, accompanied by palpitations and dizziness.
DIAGNOSIS
Radical nephrectomy was performed, and a diagnosis of clear cell carcinoma (T1N0M0, I phase) was made based on the postoperative pathology findings. With typical cellular morphology, immunophenotype and T-cell receptor gene rearrangement, a diagnosis of T-LGLL was established.
INTERVENTIONS
After radical nephrectomy, this patient remained asymptomatic without any treatment.
OUTCOMES
To date, the patient is generally in good condition, without complaints of discomfort.
LESSONS
The coexistence of these 2 entities may not be coincidental, and it is likely that they may share a common pathogenic pathway related to immune dysregulation.
原理
T细胞大颗粒淋巴细胞白血病（T-LGLL）是一种罕见的细胞毒性T细胞淋巴增殖性肿瘤，肾细胞癌（RCC）是最常见的肾癌形式，但从未有过T-LGLL与RCC相关的报道。
患者情况
一名58岁中国男性，出现全身乏力和间歇性发热，伴有心悸和头晕。
诊断
进行了根治性肾切除术，根据术后病理结果诊断为透明细胞癌（T1N0M0，I期）。结合典型的细胞形态、免疫表型和T细胞受体基因重排，确诊为T-LGLL。
干预措施
根治性肾切除术后，该患者未接受任何治疗，无症状。
结果
迄今为止，患者总体状况良好，无不适主诉。
经验教训
这两种疾病的共存可能并非巧合，它们可能共享与免疫失调相关的共同致病途径。
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