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成功治疗累及多个肾脏和骨骼浸润并表现为巨细胞动脉炎样表现的弥漫性大 B 细胞淋巴瘤。

Successful Treatment of Diffuse Large B-cell Lymphoma Involving Multiple Renal and Bone Infiltrations Presenting with Giant Cell Arteritis-like Manifestations.

机构信息

Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Japan.

Department of Hematology, Faculty of Medicine, Saitama Medical University, Japan.

出版信息

Intern Med. 2024 Jun 1;63(11):1645-1652. doi: 10.2169/internalmedicine.2377-23. Epub 2023 Nov 13.

DOI:10.2169/internalmedicine.2377-23
PMID:37952957
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11189708/
Abstract

We herein report a case of diffuse large B-cell lymphoma (DLBCL) involving multiple renal and bone infiltrations presenting with giant cell arteritis (GCA)-like manifestations. One month prior, the present patient had left-sided temporal headache, jaw claudication, and renal failure. The patient was diagnosed with DLBCL based on a renal biopsy. After rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone plus intrathecal methotrexate/cytarabine/prednisone and rituximab, high-dose methotrexate, and cytarabine chemotherapy, the patient's clinical manifestations improved, and complete remission was achieved. DLBCL rarely but occasionally presents with GCA-like manifestations or multiple renal and bone infiltrations, highlighting the need for prompt and aggressive combination chemotherapy.

摘要

我们在此报告一例累及多个肾脏和骨骼浸润的弥漫性大 B 细胞淋巴瘤（DLBCL），表现为巨细胞动脉炎（GCA）样表现。一个月前，该患者出现左侧颞部头痛、下颌跛行和肾功能衰竭。该患者基于肾活检被诊断为 DLBCL。经过利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松联合鞘内甲氨蝶呤/阿糖胞苷/泼尼松和利妥昔单抗、大剂量甲氨蝶呤和阿糖胞苷化疗后，患者的临床症状得到改善，并达到完全缓解。DLBCL 虽罕见但偶尔会出现 GCA 样表现或多个肾脏和骨骼浸润，这强调了需要及时和积极的联合化疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c67/11189708/bc5ddaa5ebab/1349-7235-63-1645-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c67/11189708/bca562bcde2a/1349-7235-63-1645-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c67/11189708/c5b55dd7bd4f/1349-7235-63-1645-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c67/11189708/b9700c0a56f6/1349-7235-63-1645-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c67/11189708/bc5ddaa5ebab/1349-7235-63-1645-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c67/11189708/bca562bcde2a/1349-7235-63-1645-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c67/11189708/c5b55dd7bd4f/1349-7235-63-1645-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c67/11189708/b9700c0a56f6/1349-7235-63-1645-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c67/11189708/bc5ddaa5ebab/1349-7235-63-1645-g004.jpg

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本文引用的文献

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Limited-stage diffuse large B-cell lymphoma.局限性期弥漫性大 B 细胞淋巴瘤。
Blood. 2022 Feb 10;139(6):822-834. doi: 10.1182/blood.2021013998.
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Diagnostic Approaches for Large Vessel Vasculitides.大血管血管炎的诊断方法
Open Access Rheumatol. 2021 Jun 1;13:153-165. doi: 10.2147/OARRR.S282605. eCollection 2021.
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Isolated oculomotor nerve palsy as a manifestation of diffuse large B cell lymphoma: A case report.孤立性动眼神经麻痹作为弥漫性大B细胞淋巴瘤的一种表现：一例报告
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Diffuse large B cell lymphoma presenting with renal failure and bone lesions in a 46-year-old woman: a case report and review of literature.46 岁女性弥漫性大 B 细胞淋巴瘤致肾衰竭和骨病变：病例报告及文献复习。
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