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一名75岁惰性淋巴瘤患者中枢神经系统病变的具有挑战性的肉芽肿性鉴别诊断

Challenging granulomatous differential diagnosis of CNS lesions in a 75-year-old patient with indolent lymphoma.

作者信息

Thurner Lorenz, Melivadze Ketevani, Matschke Jakob, Topalidis Theodoros, Bachhuber Armin, Speicher Tilman, Rosar Florian, Reischl Udo, Tränkenschuh Wolfgang, Friesenhahn-Ochs Bettina, Fries Peter, Becker Sören L, Fleser Octavian

机构信息

Department of Internal Medicine I, Saarland University Medical School, Homburg/Saar, Germany.

Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany.

出版信息

Front Immunol. 2024 Dec 4;15:1462310. doi: 10.3389/fimmu.2024.1462310. eCollection 2024.

DOI:10.3389/fimmu.2024.1462310
PMID:39697334
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11652532/
Abstract

We report here on a patient with concomitant indolent lymphoma who showed a rapid progressive deterioration of his general condition and emerging neurological symptoms. The combination of severe B symptoms with hypermetabolic involvement of the adrenal glands and multiple central nervous system (CNS) lesions initially suggested a malignant disease. However, when the patient presented to us with biopsy results from one of the CNS lesions, the biopsy revealed granulomatous inflammation but no evidence of malignancy. This case illustrates the difficulties and challenges of diagnosing in a timely manner , an ultra rare infectious disease in Europe.

摘要

我们在此报告一例伴有惰性淋巴瘤的患者，该患者出现全身状况迅速进行性恶化并伴有新发神经症状。严重的B症状、肾上腺的高代谢受累以及多个中枢神经系统（CNS）病变的组合最初提示为恶性疾病。然而，当该患者带着其中一个CNS病变的活检结果前来我们这里时，活检显示为肉芽肿性炎症，未发现恶性证据。该病例说明了及时诊断欧洲一种极为罕见的传染病的困难和挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4068/11652532/e34a37de90bf/fimmu-15-1462310-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4068/11652532/db31852b528f/fimmu-15-1462310-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4068/11652532/e34a37de90bf/fimmu-15-1462310-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4068/11652532/db31852b528f/fimmu-15-1462310-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4068/11652532/e34a37de90bf/fimmu-15-1462310-g002.jpg

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Challenging granulomatous differential diagnosis of CNS lesions in a 75-year-old patient with indolent lymphoma.一名75岁惰性淋巴瘤患者中枢神经系统病变的具有挑战性的肉芽肿性鉴别诊断
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Coccidioidomycosis and Histoplasmosis in Immunocompetent Persons.免疫功能正常者的球孢子菌病和组织胞浆菌病
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Clearance of fungal burden during treatment of disseminated histoplasmosis with liposomal amphotericin B versus itraconazole.脂质体两性霉素B与伊曲康唑治疗播散性组织胞浆菌病期间真菌负荷的清除情况。
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High serum levels of soluble interleukin-2 receptors in sarcoidosis.结节病患者血清中可溶性白细胞介素-2受体水平升高。
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Low serum interleukin-2 receptor levels correlate with a good prognosis in patients with Hodgkin's lymphoma.血清白细胞介素-2受体水平低与霍奇金淋巴瘤患者的良好预后相关。
Ann Oncol. 1991 Feb;2 Suppl 2:43-7. doi: 10.1007/978-1-4899-7305-4_7.