并发 B 淋巴瘤的脾囊肿切除术。

IF 2.5 3区 医学 Q3 ONCOLOGY
Iago Justo, Carlos Jiménez-Romero, Antonio Suárez, Pablo Vazquez, Enrique Revilla, Carmelo Loinaz, Mercedes Bernaldo de Quirós
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引用次数: 0

摘要

背景:脾囊肿并不常见,而且极少发生恶变,因此其治疗方法并不统一。对于无症状的囊肿,有不同的手术方法。脾脏原发性恶性淋巴瘤占非霍奇金淋巴瘤的比例不到 1%。据我们所知,迄今为止仅有203例脾脏大B细胞淋巴瘤(LBCL)的报道,其中只有2例是纤维蛋白相关性脾囊肿。病例介绍:27岁的患者患有一个19 × 13厘米的脾囊肿,初步研究中没有恶性肿瘤的数据,因此采用腹腔镜切除术治疗。组织学诊断为LBCL伴纤维蛋白/EBV相关性脾假性囊肿后,患者接受了4个周期的利妥昔单抗治疗,由于假性囊肿复发,患者接受了腹腔镜脾切除术。脾切除术后进行的随访(第一年每 3 个月一次 EBV 病毒载量检测,第一年每 6 个月一次 PET-CT,之后每年一次)未发现恶性肿瘤的证据:讨论与结论:肿瘤标志物和放射学诊断脾囊肿的价值受到质疑。文献中仅描述了 60 例纤维蛋白相关性低密度脂蛋白胆管癌(FA-LBCL),因此,尽管手术和全身治疗是大多数病例中疗效较好的普遍治疗方法,但目前尚无治疗指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Splenic cyst deroofing complicated with B lymphoma.

Background: Splenic cysts are uncommon and very rarely malignant therefore their treatment isn't standardized. In case of symptomatic cysts different surgical approaches have been suggested. Primary malignant lymphoma of the spleen comprises less than 1% of non-Hodgkin's lymphomas. To our knowledge, only 203 cases of splenic large B-cell lymphoma (LBCL) have been reported to date and only 2 of them were fibrin-associated splenic cysts.

Case presentation: 27-year-old model with a 19 × 13 cm splenic cyst without data of malignancy in the preliminary study and therefore treated with laparoscopic deroofing. After histological diagnosis of LBCL with a fibrin/EBV-associated splenic pseudocyst, the patient received 4 cycles of Rituximab and a laparoscopic splenectomy was performed due to resurgence of the pseudocyst. No evidence of malignancy has been found during follow up (EBV viral load every 3 months during the first year, PET-CT every 6 months during the first year and annual afterwards) performed after the splenectomy.

Discussion and conclusions: The value of tumor markers and radiology for diagnosis of splenic cysts is put into question. Only 60 cases of Fibrin-associated LBCL (FA-LBCL) have been described in the literature therefore there are no treatment guidelines for them even though surgery together with systemic treatment has been the prevalent route with good results in most cases.

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来源期刊
CiteScore
4.70
自引率
15.60%
发文量
362
审稿时长
3 months
期刊介绍: World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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