慢性淋巴细胞白血病误诊一例

【病例】　男,5 7岁。因胸闷、气促、咳嗽3个月,加重5天入院。3个月前无诱因出现干咳、胸闷、气促,活动后明显,伴左下胸部隐痛,无下肢水肿、夜间端坐呼吸及发热。当地医院胸部CT检查示:两肺未见异常病灶,两侧支气管通畅,纵隔内未见肿大淋巴结,左侧大量胸腔积液。多次抽胸水找脱     

胃癌合并红白血病一例

患者女性,71岁,农民。因腹胀、食欲减退一年,头晕、不规则高热3月于1989年9月4日收住院。病者一年来因腹胀、纳差、消瘦,先后两次作纤维胃镜检查确诊为食管下段-贲门癌,病理活检证实为腺癌。半年内采用MFC(丝裂霉素、5—氟脲嘧啶、环磷酰胺)联合化疗共八次,患者腹胀消失,食欲增加,每周查两次血象基本正常。3月前突感憋喘、心悸、骤起高热、精神恍惚急诊入院。体检:体温39.2℃,脉搏116次/分,血压11.1/6.7kpa(84/50mmHg)。神清,精神萎靡,重度贫血貌,皮肤粘膜无出血点,浅表淋巴结未触及肿大,胸骨无压痛,两肺清晰,心尖部闻及Ⅲ级吹风样收缩期杂音。腹软,未触及肿块,肝     

肺结核合并慢性淋巴细胞性白血病1例

病历摘要余△△,男,40岁,住院号1554,X线片1001、淋巴结活检号533-88°,骨髓检查号22185°。因乏力、消瘦三月,咳嗽、痰中带血伴右胸痛三天于1987年5月14日入院。既往体健。查体:瘦长体型,左颈部及右腋下触及黄豆大、蚕豆大淋巴结3～4个,滑动、触痛(±)。右上肺呼吸音减低,无病理性呼吸音。心(一)。肝肋下可及,边薄、质软。余无异常。化验:Hb95g/L,白细胞8.2×10~9/L,中性67％、淋巴33％。血沉25mm/h。其余尿、粪、血脂、生化、肾功、肝功正     

淋巴瘤合并慢性淋巴细胞性白血病1例

1病例 患者，男性，藏族，61岁，青海籍。以“反复发作腹痛伴作消瘦2月”为主诉入院，患者诉于2月来无明显诱因而间断发作腹痛，每次发作位置无明确固定，且疼痛轻重不一，以夜间腹痛明显，伴有消瘦，低烧，乏力等症状，近3天来自己触摸腹部发现有包块而前来求治，查体：BP 100／70mmHg，神志清楚，营养欠佳，发育正常，双肺呼吸音正常，心率78次／分，律齐，腹微隆起，全腹无压痛，肝脾未及，     

慢性淋巴细胞白血病合并多发性骨髓瘤

本组11例中男性8例、女性3例,起病的中位年龄70岁(45—86岁)。6例慢性淋巴细胞白血病(CLL)发生于多发性骨髓瘤(MM)之前2—3年,2例在诊断CLL时骨髓中浆细胞为1—2％,3例查了血清免疫球蛋白(Ig),其中1例单克隆IgA轻微增高。另5例为两病同时诊断。11例在CLL和MM共存阶段均有两病典型的临床表现特点。外周血淋巴细胞绝对值0.25—7.2万/mm~3,骨髓中淋巴细胞18—82％,浆细胞4—80％,其中2例病程中浆细胞分别由4％和10％上升至80％。Ig 4例为IgA,2例为IgM,1例为IgA、IgG,1例为IgD,2例为本周蛋白(BJ),1例血清中无M成份、尿中BJ( )。尿BJ检查9例( )。7例进行了CLL细胞表面Ig和MM细胞浆Ig     

慢性B淋巴细胞白血病漏诊一例

1病例资料某患者,男,60岁,2007年因感冒发热在当地医院就诊治疗,实验室检查:WBC44×109g/L,RBC4.12×1012g/L,HGB156g/L,PLT194×109g/L。白细胞分类:LYM75.4%,     

慢性淋巴细胞白血病合并肾小球肾炎、副肿瘤天疱疮一例

患者,男,41岁.2004年9月30日因发热、消瘦、颈部淋巴结肿大就诊.查体发现颈、腋窝及腹股沟多枚淋巴结肿大,肝肋缘下未及,脾肋缘下3 cm.     

淋巴细胞去除术合并CHOP方案治疗慢性淋巴细胞白血病1例

慢性淋巴细胞白血病 (CL L)复发合并肺炎 ,常规治疗效果不佳 ,病死率较高 (约占 1/ 4 ) [1 ]。本中心对 1例 CL L 患者采用淋巴细胞去除术 (TCA)并辅以中小剂量的 CHOP方案化疗 ,疗效显著 ,现报告如下。材料与方法1　研究对象　患者 ,女 ,70岁。因发热咳嗽 1月余 ,于 2 0 0 0年 10月收入杭州市第一医院。既往史 :2年前曾在本院就诊 ,诊断为慢性淋巴细胞白血病 ,经治疗症状缓解出院。本次入院体检 :全身浅表淋巴结轻度肿大 ,肝肋下未及 ,脾肋下 10 .0cm,质硬 ,腹部移动性浊音 (- ) ,双肺呼吸音粗 ,可闻及干湿口罗音。血象 :WBC5 71× …     

Synchronous gastric cancer complicated with chronic myeloid leukemia (multiple primary cancers): A case report

BACKGROUNDWith the advancement of medical technology and improvement in living standards, the incidence of multiple primary cancers has gradually increased. In particular, tumors of the digestive system account for a large proportion of multiple primary cancers. The diagnosis and treatment of chronic myeloid leukemia, particularly with synchronous gastric cancer, at the first consultation is relatively rare.CASE SUMMARYHerein, we present the case of a middle-aged man who was referred to the Department of Hematology owing to an elevated white blood cell count. After the examination, he was diagnosed with chronic myeloid leukemia and was administered imatinib. Three months after the initial diagnosis, he visited our hospital again for abdominal pain, and further examination revealed gastric malignancy. After discussion with a multidisciplinary team, S-1 (Tegafur, Gimeracil, and Oteracil Potassium Capsules) combined with oxaliplatin—SOX regimen—was initiated. Later, the patient’s condition rapidly progressed. He developed colonic obstruction and underwent an ostomy; however, he died less than 6 months after the initial diagnosis.CONCLUSIONMultiple primary cancers are influenced by environmental and genetic factors; a standardized multidisciplinary discussion plays a key role in treatment.     

Chronic lymphocytic leukemia/small lymphocytic lymphoma complicated with skin Langerhans cell sarcoma: A case report

BACKGROUNDLangerhans cell sarcoma (LCS) is a rare malignancy with poor prognosis. LCS and chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) can occur in the same diseased tissues, such as lymph nodes or skin. CASE SUMMARYA 48-year-old female Han Chinese patient was admitted for generalized lymph node enlargement for 6 years and abdominal distension for 1 wk. She was diagnosed with small B-cell lymphoma (stage IV)/CLL (Benet stage B) and received chemotherapy. She started oral ibrutinib in February 2019. She was hospitalized on June 11, 2019, and a 1.5 cm × 1.5 cm dark-red nodule with ulceration scalp lesion was found. Biopsy revealed LCS but without CLL/SLL. She was diagnosed with CLL/SLL (Binet stage C, Rai stage IV) accompanied by secondary histiocytic sarcomas and skin LCS and received cyclophosphamide, doxorubicin, vincristine, dexamethasone, and etoposide but developed severe cytopenia. She ultimately refused treatments and discharged spontaneously. She died on September 12, 2019. The literature review showed that in patients with CLL/SLL, skin lesions of LCS are accompanied by CLL/SLL. This patient was different from the previously reported cases of skin LCS in patients with CLL/SLL.CONCLUSIONIn this patient, the skin lesion of LCS showed no concomitant CLL/SLL.     

类风湿关节炎合并T-细胞大颗粒淋巴细胞白血病1例及文献复习

目的 探讨类风湿关节炎(rheumatoid arthritis, RA)合并T-细胞大颗粒淋巴细胞白血病(T-cell large granular lymphocytic leukemia,T-LGLL)的临床特点。方法 回顾性分析南京医科大学第四附属医院收治的1例RA合并T-LGLL患者的临床资料、诊疗经过并复习相关文献。结果 患者为男性,64岁,多关节肿痛10年,乏力2年。伴有中性粒细胞减少、脾大。结合患者病史、体格检查及辅助检查,入院诊断：RA,费尔蒂综合征(Felty’s syndrome, FS)。后完善相关辅助检查并结合其临床表现,确诊为T-LGLL。给予免疫抑制剂、糖皮质激素等对症治疗后,患者乏力症状改善,无关节肿痛。结论 RA和T-LGLL可能存在类似的发病途径。对RA患者,当发展为FS时,需警惕合并T-LGLL可能。     

强直性脊柱炎合并多发性骨髓瘤一例

@@     

钙化性胃癌1例

病例 女,24岁.近一月来无明显诱因出现纳差、乏力,无恶心呕吐、腹泻;近一周出现腹胀,腹围增大,外院B超示“腹腔大量积液”. CT平扫示胃壁明显增厚(图1),最厚达2.8 cm,其内见散在斑点状、粟粒状钙化影.增强扫描示增厚胃壁明显强化,其内见低密度区(图2).胃周及腹膜后见多发肿大淋巴结影,腹腔积液(图3,4).胃镜示胃底近贲门区可见一巨大不规则新生物,病变累及胃体小弯侧、胃体后壁及胃角,胃角变形,表面糜烂、出血、坏死及溃疡形成.     

Merkel cell carcinoma on the right calf in association with chronic lymphocytic leukemia: A case report

This study showed a rare case of Merkel cell carcinoma (MCC) with atypical manifestations accompanied by chronic lymphocytic leukemia of B‐cell type that underwent chemotherapy and had poor prognosis. The findings suggest that the physicians should consider MCC when performing diagnosis and assess all possible associated risk factors like neoplasms to achieve good prognosis.     

儿童急性淋巴细胞白血病21号染色体内AML1基因扩增伴TEL基因缺失一例

@@     

Chylothorax as a result of chronic lymphocytic leukemia: case report and review of the literature

Chylothorax occurs when a disruption in the thoracic duct allows chyle to escape into the pleural space. The most commonly reported cause is malignancy, especially lymphoma. However, chylothorax caused by chronic lymphocytic leukemia is rarely reported in the literature. We describe a patient who developed chylothorax secondary to chronic lymphocytic leukemia. In addition, the pathogenesis, diagnosis, and treatment of chylothorax are reviewed.