以左前臂肿物为首发表现的淋巴母细胞淋巴瘤1例
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摘要
患儿女,10个月,左肘部肿物2个月余,逐渐增大,无自觉症状。查体见左肘部紫红色质硬圆形肿物,局部B超示强回声背景下,内含不规则低回声团,边缘大致清,考虑为卡波西型血管内皮瘤。左臂肿物组织病理示:左上肢非霍奇金淋巴瘤,WHO分型:B淋巴母细胞淋巴瘤/白血病。转入血液科评估患儿骨髓等器官受累情况后,予7 d激素预化疗,VDLP(长春新碱、柔红霉素、门东酰胺酶)方案化疗,阿糖胞苷、地塞米松、甲氨蝶呤三联鞘注治疗。
A 10-month-old female presented with hard and round neoplasm on the left forearm for two months. The tumor was increasing gradually without conscious symptoms. Ultrasound of tumor showed strong echo underlying irregular low echo with clear edge, so it was considered as Kaposi form hemangioendothelioma. Pathology showed non-hodgkin′s lymphoma of the left upper limb,and the WHO classification was B 1 ymphoblastic lymphoma/leukemia. The case was transferred to hematology department for assessment of bone marrow and other organs involvement,and then the patient was pre-chemotherapy with steroid for seven days,VDLP(vincristine,daunorubicin,L-asparaginasum) for chemotherapy and cytarabine,dexamethasone,methotrexate triple intrathecal injection.
A 10-month-old female presented with hard and round neoplasm on the left forearm for two months. The tumor was increasing gradually without conscious symptoms. Ultrasound of tumor showed strong echo underlying irregular low echo with clear edge, so it was considered as Kaposi form hemangioendothelioma. Pathology showed non-hodgkin′s lymphoma of the left upper limb,and the WHO classification was B 1 ymphoblastic lymphoma/leukemia. The case was transferred to hematology department for assessment of bone marrow and other organs involvement,and then the patient was pre-chemotherapy with steroid for seven days,VDLP(vincristine,daunorubicin,L-asparaginasum) for chemotherapy and cytarabine,dexamethasone,methotrexate triple intrathecal injection.
引文
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[5] 张梦,金玲,杨菁,等.以头颅包块起病儿童B淋巴母细胞淋巴瘤6例[J].中国小儿血液与肿瘤杂志,2015,20(6):308-311.
[6] Zukerberg LR,Nickoloff BJ,Weiss SW. Kaposiform hemangioendothelioma of infancy and childhood: an aggressive neoplasm associated with Kasabach-Merritt syndrome and lymphangiomatosis[J]. Am J Surg Pathol,1993,17(4):321-328.
[2] Bollard CM,Lira MS,Gross TG,et al.Children′s Oncology Group′s 2013 blueprint for research: non-Hodgkin lymphoma[J].Pediatr Blood Cancer,2013,60(6):979-984.
[3] Lin P,Jones D,Dorfman DM,et al.Precursor B-cell lymphohlastic lymphoma:a predominantly extranodal tumor with low propensity for leukemic involvement[J]. Am J Surg Pathol,2000,24(11):1480-1490.
[4] Lee WJ,Moon HR,Won CH,et al. Precursor B- or T-lymphoblastic lymphoma presenting with cutaneous involvement: a series of 13 cases including 7 cases of cutaneous T-lymphoblastic lymphoma[J].J Am Acad Dermatol,2014,70(2):318-325.
[5] 张梦,金玲,杨菁,等.以头颅包块起病儿童B淋巴母细胞淋巴瘤6例[J].中国小儿血液与肿瘤杂志,2015,20(6):308-311.
[6] Zukerberg LR,Nickoloff BJ,Weiss SW. Kaposiform hemangioendothelioma of infancy and childhood: an aggressive neoplasm associated with Kasabach-Merritt syndrome and lymphangiomatosis[J]. Am J Surg Pathol,1993,17(4):321-328.