以重度胆汁淤积为主要表现的弥漫性大B淋巴细胞淋巴瘤1例报告

徐华谦; 魏檬; 张雪; 易海; 范方毅; 黄爱萍; 汤善宏

doi:10.3969/j.issn.1001-5256.2022.12.025

以重度胆汁淤积为主要表现的弥漫性大B淋巴细胞淋巴瘤1例报告

DOI: 10.3969/j.issn.1001-5256.2022.12.025

徐华谦^{1a, 2},
魏檬^1a,
张雪^1a,
易海^1b,
范方毅^1b,
黄爱萍^1c,
汤善宏^{1a, 2, , ,}

1a.
西部战区总医院消化内科，成都 610083
1b.
西部战区总医院血液科，成都 610083
1c.
西部战区总医院病理科，成都 610083
2.
成都中医药大学医学与生命科学学院，成都 610072

基金项目:

四川省卫生健康委员会科研课题 (20PJ180)

伦理学声明：本例报告已获得患者知情同意。

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：徐华谦参与拟定写作思路，收集分析文献，论文撰写及修改；魏檬、张雪、易海、范方毅、黄爱萍负责病例收集、资料分析、论文修改；汤善宏负责拟定写作思路，指导撰写文章与最后定稿。

详细信息

通信作者:
汤善宏，15928956390@163.com

计量
- 文章访问数: 1504
- HTML全文浏览量: 930
- PDF下载量: 77
- 被引次数: 0
出版历程
- 收稿日期: 2022-04-11
- 录用日期: 2022-05-24
- 出版日期: 2022-12-20

Diffuse large B-cell lymphoma with severe cholestasis as the main manifestation: A case report

Huaqian XU^{1a, 2},
Meng WEI^1a,
Xue ZHANG^1a,
Hai YI^1b,
Fangyi FAN^1b,
Aiping HUANG^1c,
Shanhong TANG^{1a, 2
, ,
,}

1a.
Department of Gastroenterology, The General Hospital of Western Theater Command, Chengdu 610083, China
1b.
Department of Hematology, The General Hospital of Western Theater Command, Chengdu 610083, China
1c.
Department of Pathology, The General Hospital of Western Theater Command, Chengdu 610083, China
2.
School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China

Research funding:

Scientific Research Project of Sichuan Provincial Health Commission (20PJ180)

More Information

Corresponding author: TANG Shanhong, 15928956390@163.com (ORCID: 0000-0001-6652-2942)

摘要

- 胆汁淤积 /
- 肝肿大 /
- 淋巴瘤, 非霍奇金
- Cholestasis /
- Hepatomegaly /
- Lymphoma, Non-Hodgkin

HTML全文

图 1 腹部CT表现

注：a，肝、脾肿大，肝脏上下径21.7 cm、前后径18.1 cm、左右径26.1 cm；脾脏上下径18.1 cm、左右径7.7 cm；b，腹腔多发结节影，最大为1.7 cm×1.0 cm。

Figure 1. Manifestations of abdominal CT

下载: 全尺寸图片幻灯片

图 2 肝穿刺活检病理结果

注：a，HE染色(×200)，可见异常扩大的肝脏汇管区，大量中等偏大的异形淋巴细胞浸润汇管区及肝窦；b，免疫组化CD20(+)(×200)；c，免疫组化Ki-67(+80%)(×200)。

Figure 2. Pathological results of liver biopsy

下载: 全尺寸图片幻灯片

参考文献(14)

[1]	SUN WX, LI P. Expression of SOCS3 in peripheral blood mononuclear cells of patients with diffuse large B-cell lymphoma and its effect on autophagy and apoptosis of OCI-LY7 cells[J]. J Jilin Univ(Med Edit), 2022, 48(1): 172-179. DOI: 10.13481/j.1671-587X.20220121. 孙文雄, 李蒲. SOCS3在弥漫大B细胞淋巴瘤患者外周血单个核细胞中的表达及其对OCI-LY7细胞自噬和凋亡的影响[J]. 吉林大学学报(医学版), 2022, 48(1): 172-179. DOI: 10.13481/j.1671-587X.20220121.
[2]	GUO XJ, YE JL, GOU XD, et al. Clinical value of CD138 expression in prognosis evaluation of diffuse large B cell lymphoma patients with different immunophenotypes[J]. Clin J Med Offic, 2020, 48(1): 72-74. DOI: 10.16680/j.1671-3826.2020.01.21. 郭新建, 冶俊玲, 苟笑丹, 等. CD138表达水平对不同免疫表型弥漫大B细胞淋巴瘤患者预后临床价值分析[J]. 临床军医杂志, 2020, 48(1): 72-74. DOI: 10.16680/j.1671-3826.2020.01.21.
[3]	BEUERS U, TRAUNER M, JANSEN P, et al. New paradigms in the treatment of hepatic cholestasis: from UDCA to FXR, PXR and beyond[J]. J Hepatol, 2015, 62(1 Suppl): S25-37. DOI: 10.1016/j.jhep.2015.02.023.
[4]	HILSCHER MB, KAMATH PS, EATON JE. Cholestatic liver diseases: A primer for generalists and subspecialists[J]. Mayo Clin Proc, 2020, 95(10): 2263-2279. DOI: 10.1016/j.mayocp.2020.01.015.
[5]	NGUYEN KD, SUNDARAM V, AYOUB WS. Atypical causes of cholestasis[J]. World J Gastroenterol, 2014, 20(28): 9418-9426. DOI: 10.3748/wjg.v20.i28.9418.
[6]	YAO QY, WU ZS, SHI RJ, et al. Primary splenic lymphoma with jaundice and spontaneous splenic rupture: A case report[J]. J Clin Hepatol, 2021, 37(7): 1679-1681. DOI: 10.3969/j.issn.1001-5256.2021.07.042. 姚秋艳, 吴泽生, 施荣杰, 等. 以黄疸为表现并发自发性脾破裂的原发性脾淋巴瘤1例报告[J]. 临床肝胆病杂志, 2021, 37(7): 1679-1681. DOI: 10.3969/j.issn.1001-5256.2021.07.042.
[7]	SHI Y, HAN Y, YANG J, et al. Clinical features and outcomes of diffuse large B-cell lymphoma based on nodal or extranodal primary sites of origin: Analysis of 1, 085 WHO classified cases in a single institution in China[J]. Chin J Cancer Res, 2019, 31(1): 152-161. DOI: 10.21147/j.issn.1000-9604.2019.01.10.
[8]	ITO Y, MIYAUCHI M, NAKAMURA T, et al. Significance of biopsy with ERCP for diagnosis of bile duct invasion of DLBCL[J]. Int J Hematol, 2019, 110(3): 381-384. DOI: 10.1007/s12185-019-02661-7.
[9]	CHAUDHARI D, KHAN S, SALEEM A, et al. Obstructive jaundice as an initial manifestation of non-hodgkin lymphoma: treatment dilemma and high mortality[J]. Case Rep Med, 2013, 2013: 259642. DOI: 10.1155/2013/259642.
[10]	NAKANUMA Y, TSUNEYAMA K, HARADA K. Pathology and pathogenesis of intrahepatic bile duct loss[J]. J Hepatobiliary Pancreat Surg, 2001, 8(4): 303-315. DOI: 10.1007/s005340170002.
[11]	WATTERSON J, PRIEST JR. Jaundice as a paraneoplastic phenomenon in a T-cell lymphoma[J]. Gastroenterology, 1989, 97(5): 1319-1322. DOI: 10.1016/0016-5085(89)91706-x.
[12]	WOOLF GM, PETROVIC LM, ROJTER SE, et al. Acute liver failure due to lymphoma. A diagnostic concern when considering liver transplantation[J]. Dig Dis Sci, 1994, 39(6): 1351-1358. DOI: 10.1007/BF02093804.
[13]	SHEHAB TM, KAMINSKI MS, LOK AS. Acute liver failure due to hepatic involvement by hematologic malignancy[J]. Dig Dis Sci, 1997, 42(7): 1400-1405. DOI: 10.1023/a:1018889904839.
[14]	GONZALEZ R, PARMAR P, HARDEE S, et al. Hodgkin lymphoma-related vanishing bile duct syndrome cholestasis resolved after chemotherapy[J]. J Pediatr Hematol Oncol, 2022, 44(3): e728-e732. DOI: 10.1097/MPH.0000000000002223.