Chen H M, Chen R J, Fang J F, Wang C C
Dept. of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1994 Jun;17(2):163-7.
This is a case report of a 39-year-old male. Sudden onset of abdominal pain occurred 5 months after a successful cadaveric renal transplant. The immunousuppressants chosen were cyclosporin-A, prednisolone and azathioprine. A small bowel perforation was noted 100cm proximal to ileocecal area during emergent laparotomy. Mesentery lymphadenopathy was also noted. Segmental resection with end-to-end anastomosis was done. The pathology revealed a diffuse mixed small and large cell malignant lymphoma. The postoperative course was smooth and one course of acyclovir therapy was given 2 months after the emergency procedure. From this case and literature review, we know posttransplant lymphoma of the small intestine is very rare, but it should be considered in every posttransplant victim with abdominal symptoms.
这是一例39岁男性的病例报告。在成功进行尸体肾移植5个月后，患者突然出现腹痛。选用的免疫抑制剂为环孢素A、泼尼松龙和硫唑嘌呤。急诊剖腹探查时发现回盲部近端100cm处小肠穿孔，同时还发现肠系膜淋巴结病。进行了节段性切除并端端吻合。病理显示为弥漫性混合性小细胞和大细胞恶性淋巴瘤。术后病程顺利，在急诊手术后2个月给予了一个疗程的阿昔洛韦治疗。从该病例及文献回顾可知，移植后小肠淋巴瘤非常罕见，但对于每一位有腹部症状的移植后患者都应考虑到这种情况。
