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題 名 | Primary Pleural Low Grade Lymphoma--A Case Report=原發性肋膜低度淋巴瘤--一病例報告 |
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作 者 | 許健威; 朱國安; 盧朝勇; 張晃宙; 林俊修; | 書刊名 | 胸腔醫學 |
卷 期 | 14:3 1999.09[民88.09] |
頁 次 | 頁121-126 |
分類號 | 415.43 |
關鍵詞 | 非何杰金氏淋巴瘤; 肋膜積液; 肋膜淋巴瘤; Non-Hodgkin's lymphoma; Pleural effusion; Pleural lymphoma; |
語 文 | 英文(English) |
中文摘要 | 胸部的淋巴瘤,大多以縱膈腔淋巴腺腫大來表現,局部長在肋膜上而 沒有其他器官腫大的淋巴瘤,甚為少見。大部份此類腫瘤在臨床上是以胸痛來表 現,病理上多為散在性、大細胞或immunoblastic cell、B細胞型。造成肋膜淋巴 瘤的原因,目前尚不清楚,有些文獻報告可能與Epstein-Barr病毒有關,另外在 日本則有人報告與結核菌性膿胸有關。我們報導一例肋膜上的淋巴瘤以發燒、氣 促、肋膜積液來表現,一開始當作是結核菌性肋膜炎,以抗結核藥物治療,治療 三個月後,病人肋膜積液增多,症狀未改善。重新評估,電腦斷層發現肋膜有腫 塊,切片證實為惡性淋巴瘤。施以六次化學治療,病人的症狀改善,未再有肋膜 積液蓄積。 |
英文摘要 | Primary pleural non-Hodgkin's lymphoma ( NHL ) is rare, and most pleural non-Hodgkin's lymphomas are high-grade, B cell type. We report a patient presenting with right side pleural effusion. Thoracocentesis showed lymphocytes as the predominant cells. The first pleural biopsy showed inflammatory cells infiltration and the initial presumptive diagnosis was tuberculous pleurisy. An anti-tuberculosis trial with isoniazid, rifampicin, ethambutol and pyrazinamide was then started, but the pleural effusion worsened despite three months of anti-tuberculosis therapy. Computed tomographic scan of the chest revealed a mass lesion over the right pleural cavity. Repeated thoracocentesis and thoracoscopic biopsy demonstrated malignant lymphoma, diffuse, small, lymphocytic, B cell type. There were no evidence of lymphoma outside the right pleural cavity. According to the Working Formulation classification, the lesion was a low-grade lymphoma, a less common type of pleural lymphoma. A chemotherapy regimen with endoxan 750mg/m2, epirubicin 50mg/m2, oncovin 1.4mg/m2 and prednisolone 100mg/day was given. The pleural effusion and dyspnea improved, patient is still alive after 8 months and is followed up at the out-patient department. |
本系統中英文摘要資訊取自各篇刊載內容。