Orth T, Treichel U, Mayet W J, Störkel S, Meyer zum Büschenfelde K H
I. Medizinische Klinik und Poliklinik, Universität Mainz.
Dtsch Med Wochenschr. 1994 May 13;119(19):694-8. doi: 10.1055/s-2008-1058749.
Ankle oedema and abdominal swelling suddenly developed in a 55-year-old woman who also had lymphadenopathy in the neck, axillae and groin. Ultrasonography demonstrated hepatosplenomegaly, ascites and pleural effusions. Histological examination of some lymph-nodes from the axilla and groin revealed angioimmunoblastic lymphadenopathy (low-malignant peripheral T cell lymphoma). Bone-marrow biopsy was undertaken because of a normocytic anaemia (haemoglobin 4.9 g/dl) requiring blood transfusion, thrombocytopenia (5000/microliters) and monoclonal IgG gammopathy. This showed lymphoma-associated secondary myelofibrosis. Treatment with prednisone (2 mg/kg daily for 8 weeks) and vincristine (1 mg/m2 once weekly for 4 weeks) brought about partial remission of the angioimmunoblastic lymphadenopathy with normalization of the clinical and laboratory findings, the splenohepatomegaly regressed, and there was only a small amount of ascites. Four months after onset of the illness bone-marrow biopsy also showed regression of the myelofibrosis.
一名55岁女性突然出现踝部水肿和腹部肿胀，其颈部、腋窝和腹股沟也有淋巴结病。超声检查显示肝脾肿大、腹水和胸腔积液。对腋窝和腹股沟的一些淋巴结进行组织学检查，发现血管免疫母细胞性淋巴结病（低恶性外周T细胞淋巴瘤）。由于正细胞性贫血（血红蛋白4.9g/dl）需要输血、血小板减少（5000/微升）和单克隆IgG丙种球蛋白病，进行了骨髓活检。结果显示为淋巴瘤相关的继发性骨髓纤维化。用泼尼松（每日2mg/kg，共8周）和长春新碱（每周1mg/m²，共4周）治疗后，血管免疫母细胞性淋巴结病部分缓解，临床和实验室检查结果恢复正常，脾肝肿大消退，仅残留少量腹水。发病4个月后骨髓活检显示骨髓纤维化也有所消退。
