Sieloff Eric M, Garg Alpana, Goyal Sachin, Alangaden Anjali, Lilley Kirthi K
Internal Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA.
Internal Medicine, Wayne State University Detroit Medical Center, Detroit, USA.
Cureus. 2020 Jul 13;12(7):e9162. doi: 10.7759/cureus.9162.
A 60-year-old woman presented with six months of abdominal pain, weight loss and diarrhea for which she underwent bidirectional endoscopies that were unremarkable. Over the next two weeks, she developed non-cirrhotic portal hypertension and presented with esophageal variceal bleeding. A diffuse large B-cell lymphoma encircling her celiac axis with a tumor thrombosis of the superior mesenteric, splenic and portal veins was found to be the cause of her portal hypertension. An esophagogastroduodenoscopy (EGD) was performed to control her variceal bleeding. She was started on R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy and after three cycles her symptoms have subsided, and a CT scan has shown shrinking mesenteric lymphadenopathy.
一名60岁女性因腹痛、体重减轻和腹泻6个月就诊，为此她接受了双向内镜检查，结果无异常。在接下来的两周里，她出现了非肝硬化性门静脉高压，并伴有食管静脉曲张出血。发现环绕其腹腔干的弥漫性大B细胞淋巴瘤伴肠系膜上静脉、脾静脉和门静脉肿瘤血栓形成是其门静脉高压的病因。进行了食管胃十二指肠镜检查（EGD）以控制她的静脉曲张出血。她开始接受R-CHOP（利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松）化疗，三个周期后症状缓解，CT扫描显示肠系膜淋巴结病缩小。
