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异时性混合细胞型经典型霍奇金淋巴瘤与T细胞白血病/淋巴瘤:一例报告

Metachronous mixed cellularity classical Hodgkin's lymphoma and T-cell leukemia/lymphoma: A case report.

作者信息

Dong Yang, Deng Lai-Jun, Li Mi-Mi

机构信息

Department of Clinical Pharmacy, Weifang Hospital of Traditional Chinese Medicine, Weifang 261000, Shandong Province, China.

Department of Hematology, Weifang Hospital of Traditional Chinese Medicine, Weifang 261000, Shandong Province, China.

出版信息

World J Clin Cases. 2021 Sep 26;9(27):8177-8185. doi: 10.12998/wjcc.v9.i27.8177.

Abstract

BACKGROUND

The development of peripheral T-cell lymphoma (PTCL) after chemotherapy for Hodgkin's lymphoma (HL) is rare, and highly aggressive TCL/leukemia has not been reported to date. The relationship between HL and PTCL needs further exploration to understand the pathogenesis of metachronous lymphoma (ML) and find effective treatment options. We report a patient with ML, whose biopsy of a right cervical lymph node initially confirmed classical HL (CHL).

CASE SUMMARY

We report a patient with ML, whose biopsy of a right cervical lymph node initially confirmed CHL, with typical reed-sternberg cells expressing CD30 and PAX-5. T-cell leukemia/lymphoma occurred 3 years after treatment, and a lymph node biopsy at the onset confirmed PTCL, nonspecific type, expressing CD3, CD4 and CD8. The patient was treated with standard doses of chemotherapy, programmed cell death-ligand 1 monoclonal antibody, and chidamide, all of which failed to achieve complete remission. The patient was diagnosed with refractory state, and eventually died of leukocyte stasis.

CONCLUSION

The accuracy of the diagnosis needs to be confirmed when chemotherapeutic drugs are not effective.

摘要

背景

霍奇金淋巴瘤(HL)化疗后发生外周T细胞淋巴瘤(PTCL)的情况罕见,且迄今为止尚未报道过高度侵袭性的TCL/白血病。HL与PTCL之间的关系需要进一步探索,以了解异时性淋巴瘤(ML)的发病机制并找到有效的治疗方案。我们报告1例ML患者,其右颈淋巴结活检最初确诊为经典型HL(CHL)。

病例摘要

我们报告1例ML患者,其右颈淋巴结活检最初确诊为CHL,典型的里德-斯腾伯格细胞表达CD30和PAX-5。治疗3年后发生T细胞白血病/淋巴瘤,发病时淋巴结活检确诊为非特异性型PTCL,表达CD3、CD4和CD8。该患者接受标准剂量化疗、程序性细胞死亡配体1单克隆抗体及西达本胺治疗,均未实现完全缓解。该患者被诊断为难治状态,最终死于白细胞淤滞。

结论

化疗药物无效时,诊断的准确性需要确认。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1040/8462207/ed5aac0f6c4d/WJCC-9-8177-g001.jpg

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