白血病食管浸润。
Leukemic infiltration of the esophagus.
作者信息
Fulp S R, Nestok B R, Powell B L, Evans J K, Geisinger K R, Gilliam J H
机构信息
Department of Internal Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157-1082.
出版信息
Cancer. 1993 Jan 1;71(1):112-6. doi: 10.1002/1097-0142(19930101)71:1<112::aid-cncr2820710118>3.0.co;2-1.
BACKGROUND
Leukemic infiltrates of the esophagus have been described occasionally in autopsy series, but there are no reports of antemortem diagnosis.
METHODS
Case reports are presented for three patients with acute myeloid leukemia in whom leukemic infiltration of the esophageal mucosa was diagnosed histologically and cytologically by endoscopic examination. Autopsies of patients with leukemia from 1976-1988 were reviewed.
RESULTS
The autopsy review of 207 patients with leukemia showed evidence of leukemic infiltration in the esophagus in 7.2% of cases. The only clinical factor identified to be significantly associated with esophageal involvement by leukemic cells was a high initial leukocyte count. Esophageal involvement was associated with leukemic infiltration of other soft tissues and organs.
CONCLUSIONS
Although the etiology of dysphagia in patients with acute leukemia is usually related to infection, reflux, chemotherapy toxicity, or benign strictures, the frequency of esophageal leukemic infiltration in this autopsy series suggests that this diagnosis must be considered. Esophageal leukemia is usually associated with widely disseminated soft tissue and visceral infiltrates.
背景
在尸检系列中偶尔会描述食管的白血病浸润，但尚无生前诊断的报道。
方法
报告了3例急性髓系白血病患者的病例，通过内镜检查从组织学和细胞学上诊断出食管黏膜的白血病浸润。回顾了1976年至1988年白血病患者的尸检情况。
结果
对207例白血病患者的尸检回顾显示，7.2%的病例有食管白血病浸润的证据。唯一被确定与白血病细胞累及食管显著相关的临床因素是初始白细胞计数高。食管受累与其他软组织和器官的白血病浸润有关。
结论
虽然急性白血病患者吞咽困难的病因通常与感染、反流、化疗毒性或良性狭窄有关，但该尸检系列中食管白血病浸润的频率表明必须考虑这一诊断。食管白血病通常与广泛播散的软组织和内脏浸润有关。
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