Shi Xue, Zhang Tingting, Xu Hong, Zhang Xiaoying, Zhao Hongguo, Liu Xiaodan, Hou Fang, Yang Guangjie, Liu Zhihe
Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Emergency, The Affiliated Hospital of Qingdao University, Qingdao, China.
J Int Med Res. 2020 Aug;48(8):300060520938173. doi: 10.1177/0300060520938173.
A 64-year old Chinese male patient was admitted to our hospital because of severe jaundice that persisted for 2 months. No swollen lymph nodes or hepatosplenomegaly was detected on physical examination. His laboratory data indicated high levels of direct bilirubin, alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase. No abnormality was revealed on abdominal computed tomography (CT). However, positron emission tomography (PET)-CT revealed diffuse hypermetabolism in the liver and spleen. Ultimately, liver biopsy guided by PET-CT was performed, revealing that atypical lymphocytes diffusely infiltrated the liver. The immunohistochemical analysis demonstrated that the tumor cells were positive for CD20, Bcl-2, Bcl-6, MUM1, and c-Myc but negative for CD3, CD4, CD8, and CD10. Based on these findings, this patient was diagnosed with primary hepatosplenic diffuse large B-cell lymphoma. After the definite diagnosis, he received chemotherapy and remained in good health as of September 2019.
一名64岁的中国男性患者因严重黄疸持续2个月入住我院。体格检查未发现肿大淋巴结或肝脾肿大。他的实验室数据显示直接胆红素、碱性磷酸酶、天冬氨酸转氨酶和丙氨酸转氨酶水平升高。腹部计算机断层扫描（CT）未发现异常。然而，正电子发射断层扫描（PET）-CT显示肝脏和脾脏弥漫性代谢增高。最终，在PET-CT引导下进行了肝脏活检，结果显示非典型淋巴细胞弥漫性浸润肝脏。免疫组织化学分析表明，肿瘤细胞CD20、Bcl-2、Bcl-6、MUM1和c-Myc呈阳性，但CD3、CD4、CD8和CD10呈阴性。基于这些发现，该患者被诊断为原发性肝脾弥漫性大B细胞淋巴瘤。明确诊断后，他接受了化疗，截至2019年9月，身体状况良好。
