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结直肠滤泡性淋巴瘤：一例报告。

Colorectal follicular lymphoma: A case report.

作者信息

Wang Mei-Lian, Chang Jiang, Huang Hua, Fu Wen, Niu Yi-Chun, Lu Ming-Liang, Shrestha Shikha

机构信息

Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China.

出版信息

Medicine (Baltimore). 2019 Jan;98(3):e13985. doi: 10.1097/MD.0000000000013985.

DOI:10.1097/MD.0000000000013985
PMID:30653103
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6370128/
Abstract

RATIONALE

Considering the low incidence of colorectal follicular lymphoma (FL) and its clinical features in endoscopic views, only a few studies have described the pathological diagnosis and treatment of this disease. This study aimed to reveal the overall process of clinical diagnosis and treatment of colorectal FL by conducting a case review.

PATIENT CONCERNS

A 27-year-old female presented to our department because of "severe bloody stool" lasting for more than 1 month. Her primary symptom was melena. Colonoscopy revealed widespread flat polyps with various immunophenotypes (CD10+, BCL2+, BCL6+, cyclin D1-, CD5-) in the colorectal area.

DIAGNOSIS

In accordance with manifestations on positron emission tomography-computed tomography (PET/CT), the patient was diagnosed with stage IV colorectal FL.

INTERVENTIONS

PET/CT reexamination after 2 courses of rituximab, cyclophosphamide, liposomal doxorubicin, vincristine sulfate, and hydroprednisone (R-CHOP) regimen and 3 courses of R-CHOP plus etoposide regimen for chemotherapy indicated a significant reduction in tumor burden. Subsequently, rituximab was administered alone in 2 treatment courses.

OUTCOMES

Lesions on PET/CT disappeared after reexamination. No recurrence was observed within the 12-month follow-up period.

LESSONS

Colorectal FL is a rare disease with an inert clinical course and is common in the ileocecal area. Endoscopic views show multiple polyps. Interventional treatment is usually provided after observation of clinical symptoms or during disease progression. The disease has a relatively good prognosis.

摘要

原理

鉴于结直肠滤泡性淋巴瘤（FL）的低发病率及其在内镜检查中的临床特征，仅有少数研究描述了该疾病的病理诊断和治疗。本研究旨在通过病例回顾揭示结直肠FL临床诊断和治疗的全过程。

患者情况

一名27岁女性因“严重便血”持续1个多月前来我院就诊。她的主要症状是黑便。结肠镜检查显示结直肠区域有广泛的扁平息肉，具有多种免疫表型（CD10 +、BCL2 +、BCL6 +、细胞周期蛋白D1 -、CD5 -）。

诊断

根据正电子发射断层扫描 - 计算机断层扫描（PET/CT）表现，该患者被诊断为IV期结直肠FL。

干预措施

在接受2个疗程的利妥昔单抗、环磷酰胺、脂质体阿霉素、硫酸长春新碱和氢化泼尼松（R-CHOP）方案以及3个疗程的R-CHOP加依托泊苷方案化疗后进行PET/CT复查，结果显示肿瘤负荷显著降低。随后，单独给予利妥昔单抗进行2个疗程的治疗。

结果

复查后PET/CT上的病变消失。在12个月的随访期内未观察到复发。

经验教训

结直肠FL是一种罕见疾病，临床病程惰性，在回盲部常见。内镜检查可见多个息肉。通常在观察临床症状或疾病进展期间进行介入治疗。该疾病预后相对较好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c86/6370128/003fa12e174e/medi-98-e13985-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c86/6370128/8334f6a8db75/medi-98-e13985-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c86/6370128/003fa12e174e/medi-98-e13985-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c86/6370128/8334f6a8db75/medi-98-e13985-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c86/6370128/f59c028eaf75/medi-98-e13985-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c86/6370128/b244fe1c223f/medi-98-e13985-g003.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c86/6370128/003fa12e174e/medi-98-e13985-g005.jpg

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