Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Japan.
Department of Hematology, Faculty of Medicine, Saitama Medical University, Japan.
Intern Med. 2024 Jun 1;63(11):1645-1652. doi: 10.2169/internalmedicine.2377-23. Epub 2023 Nov 13.
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.
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。