Pateria Puraskar, Martin Annalise, Khor Tze Sheng, Jayasekeran Vanoo
Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
BMJ Case Rep. 2019 Mar 21;12(3):e228186. doi: 10.1136/bcr-2018-228186.
A 59-year-oldwoman presented with a 2-month history of malaise, abdominal distention and unintentional weight loss. She was initially managed as community acquired pneumonia with a suspicion of underlying chronic liver disease but she deteriorated rapidly into a multiorgan failure necessitating transfer to intensive care unit of a tertiary hospital. She was investigated with liver and bone marrow biopsy that confirmed the diagnosis of hepatosplenic T cell lymphoma. She was treated with cyclophosphamide, doxorubicin, vincristine, etoposide and prednisolone chemotherapy that was changed to salvage ifosfamide carboplatin etoposide (ICE) chemotherapy due to poor response with first-line chemotherapy and disease progression. Unfortunately, her disease progressed further and she opted for palliative management.
一名59岁女性，出现了2个月的全身不适、腹胀和非故意体重减轻症状。她最初被当作社区获得性肺炎治疗，怀疑有潜在的慢性肝病，但病情迅速恶化为多器官功能衰竭，需要转至一家三级医院的重症监护病房。对她进行了肝脏和骨髓活检，确诊为肝脾T细胞淋巴瘤。她接受了环磷酰胺、阿霉素、长春新碱、依托泊苷和泼尼松龙化疗，由于一线化疗反应不佳且疾病进展，改为挽救性异环磷酰胺、卡铂、依托泊苷（ICE）化疗。不幸的是，她的病情进一步进展，于是选择了姑息治疗。
