- 期刊
Primary Duodenal Mucosa-Associated Lymphoid Tissue Lymphoma: Report of a Case
原發性十二指腸黏膜相關淋巴組織淋巴瘤：一病例報告
摘要
背景：原發性十二指腸黏膜淋巴癌在臨床上是很罕見的病例。目的：借由探討一位門診病患的病史及治療，使我們對這種疾病和臨床表現更了解。方法與結果：回溯分析本院96年9月至98年8月之一位門診病人之治療方法和內視鏡及病理切片之變化，並回朔相關文獻來討論原發性十二指腸黏膜淋巴癌。一位56歲女性，因上腹脹和胃食道逆流3個月而至本院門診求診。在胃鏡下十二指腸黏膜顯示多發性類息肉狀的變化，做CLO test檢驗是陽性，且病理切片顯示是原發性十二指腸黏膜淋巴癌。病人在抗生素對抗幽門螺旋桿菌及COP化學治療下，內視鏡雖有改善但仍復發，之後病人對rituximab plus COP regimen治療方式有顯著效果，且治療完後內視鏡切片已無淋巴癌細胞。
並列摘要
We present a rare case of primary duodenal mucosa-associated lymphoid tissue lymphoma (MALToma), which was refractory to eradication of helicobacter pylori and COP regimen with successful complete response to rituximab plus cyclophosphamide, vincristine, prednisolone (COP) regimen. A 56-year-old woman suffered from acid regurgitation and epigastric fullness for more than 3 months. The initial upper gastrointestinal endoscopy showed multiple whitish polypoid lesions at the proximal 2nd portion of duodenum. Rapid urease test-Camplyobacter-like organism (CLO) was positive. Initially, the polypoid lesions disappeared dramatically after H. pylori eradication, but it recurred 4 months later. The subsequent systemic chemotherapy (COP) failed to cure the disease after six months treatment. Finally, the patient had complete response to rituximab plus COP regimen verified by series of endoscopic and histological studies. The endoscopic features correlated well with histology for the prediction of disease evolution. Serial endoscopic surveys are important to validate the treatment response. Literatures related to primary duodenal MALToma are also reviewed.