异基因造血干细胞移植后中枢神经系统移植后淋巴细胞增生性疾病：长崎移植组的经验
Central nervous system post-transplant lymphoproliferative disorder after allogeneic hematopoietic stem cell transplantation: The Nagasaki transplant group experience.
作者信息
Sakamoto Hikaru, Itonaga Hidehiro, Taguchi Jun, Kato Takeharu, Sawayama Yasushi, Hayashi Tomayoshi, Baba Shiro, Moriuchi Masako, Ohshima Koichi, Yoshida Shinichiro, Moriuchi Yukiyoshi, Miyazaki Yasushi
机构信息
Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan.
Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
出版信息
Leuk Res Rep. 2019 Apr 22;11:27-30. doi: 10.1016/j.lrr.2019.04.003. eCollection 2019.
A 17-year-old male received allogeneic transplantation for acute lymphoblastic leukemia, and presented with generalized seizures due to a solitary brain lesion with massive necrosis on day +621. Epstein-Barr virus (EBV) DNA copies were below the cut-off value in plasma. Stereotactic biopsy of the cerebral lesion confirmed the diagnosis of post-transplant lymphoproliferative disorder (PTLD) with large atypical cells positive for CD20 and EBER. In order to diagnose primary central nervous system PTLD, the biopsy should be applied as early as possible when brain lesion with necrosis develops in post-transplant patients regardless of EBV-DNA in plasma.
一名17岁男性因急性淋巴细胞白血病接受了异基因移植，在移植后第621天出现全身性癫痫发作，原因是一个孤立的脑病变伴有大量坏死。血浆中爱泼斯坦-巴尔病毒（EBV）DNA拷贝数低于临界值。脑病变的立体定向活检确诊为移植后淋巴细胞增殖性疾病（PTLD），大的非典型细胞CD20和EBER呈阳性。为了诊断原发性中枢神经系统PTLD，当移植后患者出现伴有坏死的脑病变时，无论血浆中EBV-DNA情况如何，都应尽早进行活检。
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