罕见的与原发性肠道弥漫性大B细胞淋巴瘤相关的恶性溃疡：一例报告。
Rare malignant ulcer related to primary intestinal diffuse large B-cell lymphoma: A case report.
作者信息
Jia Ning, Tang Yanping, Li Yang
机构信息
Department of Gastroenterology, Tianjin Hospital of Integrated Traditional Chinese and Western Medicine.
Department of Diabetes, Tianjin Nankai District Hospital of Traditional Chinese Medicine, Tianjin, China.
出版信息
Medicine (Baltimore). 2020 Feb;99(6):e18590. doi: 10.1097/MD.0000000000018590.
RATIONALE
The specific pathogenesis of the diffuse large B-cell lymphoma(DLBCL)is still indefinite and argumentative. It is known that DLBCL is the most common type of non-Hodgkin's lymphomas (NHL). A lot of cases of DLBCL such as primary gastric diffuse large B-cell lymphoma(PG-DLBCL) are reported. However, primary intestinal diffuse large B-cell lymphoma(PI-DLBCL) is unusual.
PATIENT CONCERNS
We present a case of a 57-year-old male diagnosed in the Gastroenterology Department, which presented a bleeding duodenal ulcer with irregular borders.
DIAGNOSES
The immunohistochemical staining showed: CD20(+++), CD10(+) and Ki-67>40%.
INTERVENTIONS
The patient was successfully treated by Poly-chemotherapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vindesine and prednisolone).
OUTCOMES
After 6 courses of chemotherapy treatment, the duodenal ulcer was completely healed by reviewing the UGIE.
LESSONS
Our report might give further strength to avoiding the erroneous and missed diagnosis for PI-DLBCL which is different from common duodenal ulcer.
理论依据
弥漫性大B细胞淋巴瘤（DLBCL）的具体发病机制仍不明确且存在争议。已知DLBCL是最常见的非霍奇金淋巴瘤（NHL）类型。已报道了许多DLBCL病例，如原发性胃弥漫性大B细胞淋巴瘤（PG-DLBCL）。然而，原发性肠道弥漫性大B细胞淋巴瘤（PI-DLBCL）并不常见。
患者情况
我们报告一例57岁男性患者，在胃肠病科确诊，表现为边界不规则的十二指肠出血性溃疡。
诊断
免疫组化染色显示：CD20（+++），CD10（+），Ki-67>40%。
干预措施
患者接受了R-CHOP（利妥昔单抗、环磷酰胺、阿霉素、长春地辛和泼尼松龙）联合化疗，治疗成功。
结果
经过6个疗程的化疗后，复查上消化道内镜检查显示十二指肠溃疡完全愈合。
经验教训
我们的报告可能会进一步有力地避免对与普通十二指肠溃疡不同的PI-DLBCL的误诊和漏诊。
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