Huang Li, Meng Can, Liu Dan, Fu Xiang-Jun
Department of Hematology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China.
World J Clin Cases. 2021 Aug 26;9(24):7237-7244. doi: 10.12998/wjcc.v9.i24.7237.
Multiple primary cancer refers to more than one synchronous or sequential cancer in the same individual. Multiple primary cancer always presents as solid cancer or acute myeloid leukemia (AML) secondary to lymphoma. Here, we report a rare case of secondary peripheral T-cell lymphoma and AML after Burkitt lymphoma treatment.
A 54-year-old female patient was admitted to our hospital complaining of edema on her left lower limb. Physical examination revealed multiple superficial lymphadenectasis on her neck and pelvis. Color ultrasonography examination showed multiple uterine fibroids and a solid mass at the lower left side of the abdomen. Pathological biopsy revealed Burkitt lymphoma. After three hyper-CVAD (A + B) regimens, she achieved complete remission. Two years later, lymphadenectasis reoccurred. A relevant biopsy confirmed the diagnosis of peripheral T-cell lymphoma, which was accompanied by gastrointestinal invasion and hemocytopenia. Meanwhile, bone marrow examination revealed AML. On the second day of scheduled treatment, she developed gastrointestinal bleeding, peptic ulcers, and hemorrhagic shock and was critically ill. She was then discharged from the hospital due to financial concerns.
This is the first report of secondary peripheral T-cell lymphoma and AML after Burkitt lymphoma treatment with heterochronous and synchronal multiple primary cancers.
多原发性癌是指同一个体中出现一种以上同时性或异时性癌。多原发性癌通常表现为实体癌或继发于淋巴瘤的急性髓系白血病(AML)。在此,我们报告1例伯基特淋巴瘤治疗后发生继发性外周T细胞淋巴瘤和AML的罕见病例。
一名54岁女性患者因左下肢水肿入院。体格检查发现其颈部和盆腔有多处浅表淋巴结肿大。彩色超声检查显示多发性子宫肌瘤及左下腹实性肿块。病理活检确诊为伯基特淋巴瘤。经过3个周期的高强度化疗方案(A+B)后,患者达到完全缓解。两年后,淋巴结肿大复发。相关活检确诊为外周T细胞淋巴瘤,伴有胃肠道侵犯及血细胞减少。同时,骨髓检查显示为AML。在预定治疗的第二天,患者出现消化道出血、消化性溃疡及失血性休克,病情危重。随后因经济原因出院。
这是首例伯基特淋巴瘤治疗后出现异时性和同时性多原发性癌继发外周T细胞淋巴瘤和AML的报告。