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題名 | Posttransplantation Lymphoproliferative Disorder after Lung Transplantation=肺臟移植術後之移植後淋巴增生性病變:一病例報告 |
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作者 | 陳晉興; 陸希平; 張逸良; 李章銘; 黃重傑; 張允中; 李元麒; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 31:5 民87.09-10 |
頁次 | 頁314-319 |
分類號 | 416.224 |
關鍵詞 | 肺臟移植; 移植後淋巴增生性病變; Posttransplantation lymphoproliferative disorder; Lung transplantation; Sauropus androgynus; |
語文 | 英文(English) |
中文摘要 | 移植後淋巴增生性病變[Posttransplantation lymphoproliferative disorder, PTLD] 是器官移植術後一個相當罕見卻足以致命之併發症,較常發生於兒童或接受肺臟移植之病人。就病理學而言,此症包含各種來源不同且形態各異之淋巴球性增生。這些淋巴球大多數是 B 細胞,同時絕大多數之病例皆合併有Epstein-Barr病毒之感染。我們報告一位四十四歲女性因服用減肥菜[Sauropus androgynus]引起阻塞性細支氣管炎[Bronchiolitis obliterans] 而接受肺臟移植之病例。病患之移植肺於術後三個月出現三顆結節。這些結節在經過血清學檢查及電腦斷層指引之組織切片後,證實為和Epstein-Barr病毒感染無關之B細胞淋巴癌。病患隨後雖即接受抗病毒藥物治療,減少免疫抑制劑之劑量,甚至使用化學治療,但結節仍持續快速變大。病患於移植後五個月因敗血症及呼吸衰竭而死亡。 |
英文摘要 | Posttransplantation lymphoproliferative disorder (PTLD) is an uncommon but often fatal complication of solid organ transplantation. The incidence is relatively higher in pediatric patients or patients undergoing lung transplantation. The pathology of PTLD is a morphologically heterogeneous group of lymphoid proliferation of varying clonal composition, most commonly of B-cell origin, and the Epstein-Barr virus (EBV) has been implicated as a cofactor in most cases. Herein we report a 44-year-old woman who underwent right single lung transplantation because of bronchiolitis obliterans associated with Sauropus androgynus ingestion. Three nodules were noted at the grafted lung 3 months after the operation. The CT-guided biopsies and serological studies revealed that these nodules were EBV-unrelated B-cell lymphoma. Despite treatment including antiviral agents, reduction of immunosuppression, as well as conventional chemotherapy, these nodules increased in size rapidly. This patient died of sepsis and respiratory failure 5 months after the transplantation. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。