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以染色体 16 重排为特征的急性髓系白血病的首发表现为急性胰腺炎。

Acute pancreatitis as the initial manifestation of acute myeloid leukemia with chromosome 16 rearrangements.

机构信息

Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

Int J Hematol. 2023 Sep;118(3):381-387. doi: 10.1007/s12185-023-03580-4. Epub 2023 Mar 25.

Abstract

Acute pancreatitis is an acute inflammatory process of the pancreas that is becoming an increasingly common clinical issue. The most frequent underlying etiologies include gallstones and chronic alcohol use, which account for more than two-thirds of cases. We recently experienced a rare case of acute myeloid leukemia (AML) presenting with recurrent acute pancreatitis, which we later discovered was caused by diffusely infiltrating extramedullary sarcoma in the pancreas. Comprehensive analysis of previous cases of AML presenting as acute pancreatitis suggested involvement of cytogenetic alterations in chromosome 16 in its pathogenesis. Further improvement in management of acute pancreatitis is needed, and clinicians should note that this occasionally fatal condition can be the initial and only manifestation of AML. In practice, prompt initiation of intensive chemotherapy is critical for treating such cases of AML-induced acute pancreatitis.

摘要

急性胰腺炎是一种胰腺的急性炎症过程,正成为一种越来越常见的临床问题。最常见的潜在病因包括胆石症和慢性酒精使用,这两种病因占病例的三分之二以上。我们最近遇到了一例罕见的急性髓系白血病(AML)表现为反复发作性急性胰腺炎的病例,后来发现这是由胰腺弥漫浸润性骨髓外肉瘤引起的。对以前表现为急性胰腺炎的 AML 病例的综合分析表明,其发病机制涉及染色体 16 上细胞遗传学改变。需要进一步改善急性胰腺炎的治疗,临床医生应注意到这种偶尔致命的情况可能是 AML 的首发和唯一表现。实际上,及时开始强化化疗对于治疗这种 AML 引起的急性胰腺炎至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/854a/10415496/66412e413540/12185_2023_3580_Fig1_HTML.jpg

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