- 期刊
多發性淋巴瘤樣息肉症：兩個病例報告
Multiple Lymphomatous Polyposis: Reports of Two Cases
摘要
多發性淋巴瘤樣息肉症(multiple lymphomatous polyposis, MLP)於華人中極少見，該疾病好發於50-60歲男性，其主要症狀為腹痛、血便、腹瀉，及吸收不良等。其好發部位以大腸最多，其次為小腸、胃與食道，罹患部位若是在迴盲區，其所生長之腫瘤體積最大。多發性淋巴瘤樣息肉症為非何杰金氏淋巴瘤(non-Hodgkin’s lymphoma, NHL)之一，大多源自B細胞。病例一為一位63歲女性病患，為海洋性貧血患者，其病灶發現於直腸至盲腸區，病理診斷為低級B細胞小中心球淋巴瘤，先經外科切除術及化療，經緩解二年後復發，再經外科切除術及化療，共維持16個月後病情惡化且病灶擴散至胃、小腸及週邊淋巴腺;患者自確定診斷經治療，共存活40個月。病例二為一位60歲男性病患，其淋巴瘤診斷為一級濾泡性淋巴瘤，先發現於週邊淋巴結，經化療後曾有三年緩解，後於胃腸系統發現多發性息肉且大小不等，病理診斷為小裂淋巴球瘤，與先前週邊淋巴結切片檢查相符合。患者再經化療加上抗CD-20抗體(Rituximab)治療後，病灶變小達到緩解，但經72個月後病患仍死於該疾病。
並列摘要
Multiple lymphomatous polyposis (MLP) is rare in Chinese. The disease is more common in men, 50-60 years old. Its main clinical manifestations include abdominal pain, bloody stool, diarrhea, malabsorption, etc. The disease is more common in the large intestine, then small intestine, stomach and esophagus. The largest tumor is usually found in the ileocecal region. This kind of non-Hodgkin's lymphoma (NHL) is mostly originated from B cells. Case 1 was a 63-year-old female. She was a patient with thalassemia. Her tumor mass was found from the rectum to cecum with a diagnosis of B cell, low grade, small centrocytic lymphoma. She received surgical resection and chemotherapy. The disease recurred after 2 years of remission. She received surgical resection and chemotherapy again. However, the disease became worse 16 months later, even under the treatment. She survived for 40 months after the diagnosis of lymphoma, MLP, being made. Case 2 was a 60- year-old male. His tumor was diagnosed as a case of malignant lymphoma, FCC type, grade 1 in his peripheral lymph nodes primarily. He received chemotherapy and got remission of the disease. After 3 years, multiple polyposes with different sizes were found in the GI system. A pathological diagnosis of lymphoma with small cleared lymphocytes was made. It was compatible with the findings in the previous biopsies of LNs. Despite of the lymphomatous masses remained after treating with chemotherapy combined with anti-CD20 treatment, the patient's conditions had got partial remission but finally become refractory and survive over a periods of 72 months after the diagnosis.