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一名41岁女性患伴有肉瘤样变异型的间变性大细胞淋巴瘤（ALCL）并表现为分布性休克：病例报告

Anaplastic Large Cell Lymphoma (ALCL) With a Sarcomatoid Variant Presenting As Distributive Shock in a 41-Year-Old Female: A Case Report.

作者信息

Alhusari Leena, Abdallah Mahmoud, Dakkak Bassel, Bsiso Taysir, Jamil Muhammad

机构信息

Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

Hematology and Medical Oncology, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

出版信息

Cureus. 2024 Feb 29;16(2):e55235. doi: 10.7759/cureus.55235. eCollection 2024 Feb.

DOI:10.7759/cureus.55235
PMID:38558574
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10981390/
Abstract

The sarcomatoid variant is considered a rare subtype of anaplastic large cell lymphoma. We present a 40-year-old diabetic female who was evaluated in the ER for distributive shock, requiring vasopressors and mechanical ventilation. An extensive workup was negative for infection. A serial CT scan of the abdomen and pelvis showed evolving lymphadenopathy, and a biopsy revealed malignant anaplastic lymphoma cells with a sarcomatous variant. The oncology team recommended the initiation of inpatient chemotherapy; however, the family opted to proceed with comfort care measures.

摘要

肉瘤样变体被认为是间变性大细胞淋巴瘤的一种罕见亚型。我们报告一名40岁的糖尿病女性，因分布性休克在急诊室接受评估，需要使用血管加压药和机械通气。全面检查未发现感染迹象。腹部和骨盆的系列CT扫描显示淋巴结病不断发展，活检显示为具有肉瘤样变体的恶性间变性淋巴瘤细胞。肿瘤学团队建议开始住院化疗；然而，家属选择采取舒适护理措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/691f/10981390/7239099985c9/cureus-0016-00000055235-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/691f/10981390/7239099985c9/cureus-0016-00000055235-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/691f/10981390/7239099985c9/cureus-0016-00000055235-i01.jpg

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本文引用的文献

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Anaplastic large cell lymphoma: pathology, genetics, and clinical aspects.间变性大细胞淋巴瘤：病理学、遗传学及临床方面
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Sarcomatoid variant of ALK- anaplastic large cell lymphoma involving multiple lymph nodes and both lungs with production of proinflammatory cytokines: report of a case and review of literature.间变性淋巴瘤激酶（ALK）阴性间变性大细胞淋巴瘤的肉瘤样变型累及多个淋巴结及双肺并产生促炎细胞因子：1例报告及文献复习
Int J Clin Exp Pathol. 2014 Jul 15;7(8):4806-16. eCollection 2014.
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Clinical presentation of anaplastic large-cell lymphoma in the central nervous system.
间变性大细胞淋巴瘤在中枢神经系统中的临床表现。
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Anaplastic lymphoma kinase-positive diffuse large B-cell lymphoma: a rare clinicopathologic entity with poor prognosis.间变性淋巴瘤激酶阳性弥漫性大B细胞淋巴瘤：一种预后不良的罕见临床病理实体。
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Sarcomatoid variant of anaplastic large cell lymphoma mimics ALK-1-positive inflammatory myofibroblastic tumor in bladder.间变性大细胞淋巴瘤的肉瘤样变体在膀胱中模仿ALK-1阳性炎性肌成纤维细胞瘤。
Am J Surg Pathol. 2005 Jun;29(6):838-9; author reply 839. doi: 10.1097/01.pas.0000159105.41103.1f.
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Sarcomatoid variant of anaplastic large cell lymphoma mimicking a primary breast cancer: a challenging diagnosis.间变性大细胞淋巴瘤的肉瘤样变体酷似原发性乳腺癌：一项具有挑战性的诊断。
Arch Pathol Lab Med. 2002 Jun;126(6):723-6. doi: 10.5858/2002-126-0723-SVOALC.
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Leuk Lymphoma. 2001 Feb;40(5-6):599-611. doi: 10.3109/10428190109097658.
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