Ellenrieder V, Beckh K, Müller D, Klatt S, Adler G
Department of Internal Medicine, University of Ulm, Germany.
Z Gastroenterol. 1996 May;34(5):283-5.
A 61-year-old white female with chronic hepatitis C virus (HCV) infection first diagnosed in 1994 was admitted with two newly discovered lesions in the liver suspected to represent hepatocellular carcinoma. The alpha-1-fetoprotein (AFP) level was within normal limits and there was neither clinical nor sonographic evidence of liver cirrhosis. Fine needle aspiration, however, showed an high-grade malignant centroblastic non-Hodgkin lymphoma (NHL). Staging failed to confirm extrahepatic involvement. Both a cryoglobulinemia and HIV infection were ruled out. Although the coincidence of HCV infection and NHL is not well recognized, recent studies have indicated an increased incidence of NHL and hepatitis C in up to 38% of patients with cryoglobulinemia. In these patients, the diagnosis is always one of a low-grade lymphoma. Based on its lymphoproliferative characteristics, an etiologic role for HCV in the development of NHL has been discussed, though the exact pathogenesis remains unclear.
一名61岁的白人女性，1994年首次被诊断为慢性丙型肝炎病毒（HCV）感染，因肝脏新发现两个疑似肝细胞癌的病灶而入院。甲胎蛋白（AFP）水平在正常范围内，且无肝硬化的临床及超声证据。然而，细针穿刺显示为高级别恶性中心母细胞性非霍奇金淋巴瘤（NHL）。分期检查未证实有肝外受累。冷球蛋白血症和HIV感染均被排除。虽然HCV感染与NHL的巧合尚未得到充分认识，但最近的研究表明，在高达38%的冷球蛋白血症患者中，NHL和丙型肝炎的发病率有所增加。在这些患者中，诊断通常为低级别淋巴瘤。基于其淋巴细胞增殖特性，虽然确切发病机制尚不清楚，但已讨论了HCV在NHL发生中的病因学作用。
