Yasunaga M, Hodohara K, Uda K, Miyagawa A, Kitoh K, Andoh A, Okabe H, Ochi Y, Fujiyama Y, Bamba T
Second Department of Internal Medicine, Shiga University of Medical Science, Japan.
Acta Haematol. 1995;93(2-4):98-100. doi: 10.1159/000204119.
We describe two patients with non-Hodgkin's lymphoma (NHL) who suffered cytomegalovirus (CMV)-related small intestinal perforations during the course of chemotherapy. Surgical specimens from both patients revealed histologic evidence of occlusive vasculitis and tissue destruction caused by CMV-affected cells in the submucosa and muscular walls, that may have played an important role in the pathogenesis of these perforations. Although such intestinal perforations are rare complications in NHL patients, CMV infection should be recognized as a primary etiological factor in acute abdominal crises when treating NHL patients with pharmaceutical agents including steroids. Emergency surgery and the anti-CMV agent, ganciclovir, would improve the prognoses of such patients.
我们描述了两名非霍奇金淋巴瘤（NHL）患者，他们在化疗过程中发生了与巨细胞病毒（CMV）相关的小肠穿孔。两名患者的手术标本均显示有闭塞性血管炎的组织学证据，以及黏膜下层和肌层中受CMV感染的细胞所导致的组织破坏，这可能在这些穿孔的发病机制中起了重要作用。尽管这种肠道穿孔在NHL患者中是罕见的并发症，但在用包括类固醇在内的药物治疗NHL患者时，CMV感染应被视为急性腹部危象的主要病因。急诊手术和抗CMV药物更昔洛韦可改善此类患者的预后。
