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[富于T细胞的B细胞淋巴瘤。3例病例报告]

[T-cell-rich B-cell lymphoma. Presentation of 3 cases].

作者信息

Rodríguez J N, Borrero J J, Fernández-Jurado A, Creagh R, Martino M L, Aguayo M, Prados D

机构信息

Servicio de Hematología, Hospital Juan Ramón Jiménez, Huelva.

出版信息

Sangre (Barc). 1997 Oct;42(5):419-22.

PMID:9424746
Abstract

T-cell-rich B-cell lymphoma (TBL) is a rare entity not included in the classical classifications of non-Hodgkin's lymphomas (NHL), presenting usually at diagnosis in advanced stages and with extranodal involvement. Its differential diagnosis, based on immunophenotyping technics, include other entities with different treatment and prognosis, mainly lymphocytic-predominance Hodgkin disease and peripheral T-cell lymphoma; this differential diagnosis has importance in patient's survival. We present 3 patients, two males (one of them with HIV infection) and one female, aged 38, 60 and 64 respectively, diagnosed as having TBL. The two former patients presented advanced stages at diagnosis. None of them was initially diagnosed as having TBL, the diagnosis were immunoblastic NHL in the first patient, peripheral T-cell lymphoma in the second and mixed cellularity Hodgkin's disease in the third one. The first patient was not treated due to rapid worsening and early death of septic shock; the other two cases were treated with COP-BLAM/IMVP-16 protocol achieving partial and complete remission respectively after 6 cycles of treatment. Comments about clinical, pathological and differential diagnostic aspects are made.

摘要

富含T细胞的B细胞淋巴瘤(TBL)是一种罕见的实体瘤,未被纳入非霍奇金淋巴瘤(NHL)的经典分类中,通常在诊断时处于晚期且伴有结外受累。基于免疫表型技术,其鉴别诊断包括其他具有不同治疗方法和预后的实体瘤,主要是淋巴细胞为主型霍奇金病和外周T细胞淋巴瘤;这种鉴别诊断对患者的生存具有重要意义。我们报告3例患者,2例男性(其中1例感染HIV)和1例女性,年龄分别为38岁、60岁和64岁,均被诊断为TBL。前2例患者诊断时处于晚期。最初均未诊断为TBL,第1例患者最初诊断为免疫母细胞性NHL,第2例为外周T细胞淋巴瘤,第3例为混合细胞型霍奇金病。第1例患者因败血症休克迅速恶化和早期死亡未接受治疗;其他2例患者采用COP - BLAM/IMVP - 16方案治疗,治疗6个周期后分别达到部分缓解和完全缓解。文中对临床、病理和鉴别诊断方面进行了讨论。

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