Jacobs P, Dubovsky D W, King H S, Blumenthal I
S Afr Med J. 1982 May 8;61(19):711-3.
A 32-year-old man presented with left hypochondrial pain and myalgia. On examination he was found to have widespread lymphadenopathy and splenomegaly, and lymph node biopsy revealed diffuse lymphocytic lymphoma of the small cleaved cell type. There was hypereosinophilia (20 x 10(9)/1). The patient was initially treated with chlorambucil and prednisone, which controlled the lymphoma for 9 months but did not affect the eosinophilia. He then developed thrombocytopenia with further lymph node enlargement which was managed with a combination of bleomycin, vincristine and prednisone; this again controlled both spleen and lymph node size without affecting the eosinophilia. Six months after presentation the patient developed refractory cardiorespiratory failure due to endomyocardial fibrosis and fibrosing alveolitis. The cardiac failure was thought to be related to the hypereosinophilia resulting from the lymphoma, while the respiratory insufficiency was attributed to the bleomycin. This case illustrates the rare association between lymphocytic lymphoma and eosinophilia and shows that cardiac damage can be associated with these cells.
一名32岁男性出现左季肋部疼痛和肌痛。检查发现他有广泛的淋巴结病和脾肿大，淋巴结活检显示为小裂细胞型弥漫性淋巴细胞淋巴瘤。存在嗜酸性粒细胞增多（20×10⁹/L）。患者最初接受苯丁酸氮芥和泼尼松治疗，该方案控制淋巴瘤达9个月，但未影响嗜酸性粒细胞增多情况。随后他出现血小板减少伴淋巴结进一步肿大，采用博来霉素、长春新碱和泼尼松联合治疗；这再次控制了脾脏和淋巴结大小，但未影响嗜酸性粒细胞增多。就诊6个月后，患者因心内膜纤维化和纤维化肺泡炎发展为难治性心肺衰竭。心力衰竭被认为与淋巴瘤导致的嗜酸性粒细胞增多有关，而呼吸功能不全归因于博来霉素。该病例说明了淋巴细胞淋巴瘤与嗜酸性粒细胞增多之间罕见的关联，并表明心脏损害可能与这些细胞有关。
