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Hepato-splenic lymphoma:a rare entity mimicking acute hepatitis:A case report

查看全文 作　　者：Federico [1]Perfetto;Roberto [1]Tarquini;Francesco [1]Mancuso;Simonetta di [2]Lollo;Silvia [2]Tozzini;Giampiero [3]Bellesi;Giacomo [3]Laffi 高影响力作者 机构地区：[1]Department of Internal Medicine,University of Florence,Italy;[2]Department of Human Pathology and Oncology,University of Florence,Italy;[3]Department of Hematology,University of Florence,Italy高影响力机构 出　　处：《World Journal of Gastroenterology》索引2003年第9卷第6期,共4页高影响力期刊 摘　　要：We reported a case of non-Hodgkin's lymphoma where liver involvement was the predominant clinical manifestation. A 27-year old man presented wiht markedly elevated serum aspartate aminotrasferase, alanine aminotransferase and lactate dehydrogenase, reduced prothrombin activity, thrombocytopenic purpura and hepato-splenomegaly without adenopathy. Viral, toxic,autoimmune and metabolic liver diseases were excluded.Bone marrow biopsy showed an intracapillary infiltration of T-lymphocytes with no evidence of lipid storage disease.Because of a progressive spleen enlargement, splenectomy was performed. Histological examination showed lymphomatous intrasinuses invasion of the spleen.Immunohistochemical investigation revealed the T phenotype of the neoplastic cells: CD45+, CD45RO+,CD3+, CD4-, CD8-, TIA1-. About 50 % of the lymphoid cells expressed CD56 antigen. The diagnosis of hepatosplenic T cell lymphoma was done. The patient was treated with chemotherapy, which induced a complete remission. Eighteen months later, he had a first relapse with increased aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase,thrombocytopenic purpura and blast in the peripheral blood.In spite of autologous bone marrow transplantation, he died twenty months after the diagnosis. Even in the absence of a mass lesion or lymphoadenopathy, hepatosplenic Tcell lymphoma should be considered in the differential diagnosis of a patient whose clinical course is atypical for acute hepatic dysfunction. 关 键 词：肝脾淋巴瘤 临床表现 急性肝炎 病例报告
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