Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University, Katsushika Medical Center, 6-41-2 Aoto, Katsushika-Ku, Tokyo, 105-8461, Japan.
Division of Clinical Oncology and Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Clin J Gastroenterol. 2023 Aug;16(4):543-549. doi: 10.1007/s12328-023-01811-z. Epub 2023 May 19.
While colorectal cancer is a likely complication associated with inflammatory bowel diseases such as ulcerative colitis, malignant lymphoma occurs less frequently. We report the case of a patient with ulcerative colitis having Epstein-Barr virus-positive diffuse large B-cell lymphoma, not otherwise specified (EBV + DLBCL, NOS), which was maintained in clinical remission with 5-aminosalicylic acid. The patient had received a diagnosis of total ulcerative colitis 5 years ago. A recent colonoscopy revealed a 35 mm protruding lesion with depression in the sigmoid colon, and histopathological examination confirmed the presence of EBV + DLBCL, NOS. The patient has undergone six courses of chemotherapy without recurrence of lymphoma and will continue to be monitored periodically. Patients with ulcerative colitis must be followed up with periodic colonoscopies and imaging studies regardless of their background, treatment, and symptoms to ensure the prevention of complications. Furthermore, while special attention must be paid to the commonly occurring colorectal cancer on account of its association with the patient's prognosis, the possibility of the incidence of malignant lymphoma must not be ignored.
虽然结直肠癌是溃疡性结肠炎等炎症性肠病的一种可能并发症，但恶性淋巴瘤的发生率较低。我们报告了一例溃疡性结肠炎患者患有 EBV 阳性弥漫性大 B 细胞淋巴瘤，非特指型（EBV+DLBCL，NOS），该患者在接受 5-氨基水杨酸治疗后处于临床缓解状态。该患者 5 年前被诊断为全结肠炎。最近的结肠镜检查显示乙状结肠有一个 35 毫米的凸起病变，伴有凹陷，组织病理学检查证实存在 EBV+DLBCL，NOS。该患者已接受了六轮化疗，未出现淋巴瘤复发，将继续定期监测。无论患者的背景、治疗和症状如何，溃疡性结肠炎患者都必须定期进行结肠镜检查和影像学研究，以确保预防并发症。此外，虽然由于与患者预后相关，必须特别注意常见的结直肠癌，但也不能忽视恶性淋巴瘤的发生可能性。
