Staples W G, Gétaz E P, Botha D
S Afr Med J. 1977 Oct 15;52(17):680-3.
Tuberculosis often complicates lymphoma, and bone marrow necrosis has been described in disseminated tuberculosis. However, the association of lymphoma, disseminated tuberculosis and bone marrow necrosis is rare. We report a patient with this triple association. After a 3-week influenza-like illness the patient was admitted to hospital semicomatose with pancytopenia and hyponatraemia. During routine examination a bone marrow trephine biopsy revealed diffuse lymphomatous infiltration with scattered necrotic foci. On Ziehl-Neelsen staining these foci exhibited numerous acid-fast bacilli. The patient subsequently died and at autopsy was found to have widely disseminated non-reactive tuberculosis.
结核病常使淋巴瘤病情复杂化，且播散性结核病中已有骨髓坏死的相关描述。然而，淋巴瘤、播散性结核病和骨髓坏死同时存在的情况较为罕见。我们报告了一位出现这种三联征的患者。在经历了为期3周的流感样疾病后，该患者因全血细胞减少和低钠血症而呈半昏迷状态入院。在常规检查中，骨髓环钻活检显示有弥漫性淋巴瘤浸润，并伴有散在的坏死灶。经萋-尼染色，这些病灶中有大量抗酸杆菌。患者随后死亡，尸检发现有广泛播散的无反应性结核病。
