Faigel D O, Vaughn D J, Furth E E, Metz D C
Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, USA.
Am J Gastroenterol. 1995 Apr;90(4):635-7.
In contrast to the acute leukemias, chronic lymphocytic leukemia (CLL) is a hematological malignancy with a generally good prognosis. Gastrointestinal (GI) involvement with CLL is unusual, and GI complications generally occur after malignant transformation to diffuse large cell lymphoma (Richter's syndrome). We present a case of CLL directly infiltrating the gastro-esophageal junction resulting in upper GI hemorrhage. This is only the second such case in the literature. We emphasize the consideration of direct leukemic infiltration in addition to Richter's syndrome in the differential diagnosis of GI bleeding in patients with CLL. Whereas the prognosis of Richter's syndrome is poor, CLL involvement of the GI tract may respond to treatment with chemo- or radiotherapy.
与急性白血病不同，慢性淋巴细胞白血病（CLL）是一种预后通常较好的血液系统恶性肿瘤。CLL累及胃肠道并不常见，胃肠道并发症通常发生在恶性转化为弥漫性大细胞淋巴瘤（里氏综合征）之后。我们报告一例CLL直接浸润胃食管交界导致上消化道出血的病例。这是文献中报道的第二例此类病例。我们强调，在CLL患者胃肠道出血的鉴别诊断中，除了考虑里氏综合征外，还应考虑白血病的直接浸润。里氏综合征预后较差，而CLL累及胃肠道可能对化疗或放疗有反应。
