Smiyan Svitlana, Galaychuk Igor, Zhulkevych Igor, Nykolyuk Volodymyr, Komorovsky Roman, Gusak Sofiya, Bilozetsky Ivan
2 Department of Internal Medicine, Ivan Horbachevsky Ternopil State Medical University, Ukraine.
Department of Oncology and Radiology, Ivan Horbachevsky Ternopil State Medical University, Ukraine.
Reumatologia. 2019;57(1):59-62. doi: 10.5114/reum.2019.83242. Epub 2019 Feb 28.
Lyme disease is a multisystem tick-borne transmissive disease with heterogeneous manifestations, frequently making the diagnosis difficult in clinical practice. Herein, we report a case of a 43-year-old female patient who presented with generalized lymphadenopathy requiring a further diagnostic evaluation towards lymphoma. The patient also had clinical signs of Sjögren's syndrome. Lymph node excision with subsequent histological and immunohistochemical studies were performed. While light microscopy findings were suspicious for lymphoma, immunohistochemistry results were consistent with cortical and paracortical lymph node hyperplasia with no evidence of lymphoproliferative disorder. Further laboratory testing confirmed the presence of Lyme borreliosis. Effectiveness of the administered antibiotic therapy confirmed Borrelia burgdorferi infection. Interrelationships between Sjögren's syndrome, lymphadenopathy and Lyme disease are discussed.
莱姆病是一种多系统蜱传性疾病，临床表现多样，在临床实践中常难以诊断。在此，我们报告一例43岁女性患者，该患者出现全身淋巴结肿大，需要进一步评估以诊断淋巴瘤。该患者还有干燥综合征的临床体征。进行了淋巴结切除及后续的组织学和免疫组化研究。虽然光学显微镜检查结果怀疑为淋巴瘤，但免疫组化结果显示为皮质和副皮质淋巴结增生，无淋巴增殖性疾病证据。进一步的实验室检测证实存在莱姆疏螺旋体病。所给予的抗生素治疗的有效性证实了伯氏疏螺旋体感染。本文还讨论了干燥综合征、淋巴结肿大与莱姆病之间的相互关系。
