縱隔腔Hodgkin氏淋巴瘤－病例報告

Mediastinum Hodgkin's Lymphoma-A Case Report

周宇光(Yu-Kung Chou) ； 凃白河(Bair-Her Twu) ； 李世俊(Shin-Chun Lee) ； 藍功堯(Gong-Yan Lan) ； 江榮華(Rong-Hwa Chiang)

《Journal of Medical Sciences》 9卷1期 (1988/02) Pp. 77-84

摘要

本病例是一個4歲男孩，由於間斷的發燒及盜汗約有1月且體重減少一公斤，故轉入本院檢查治療。病患外觀正常，無局部淋巴結腫大及皮膚病變，唯胸部X光片顯示右邊肺葉靠縱隔部有一邊緣清楚的腫瘤。實驗診斷呈現血液嗜伊紅性球增加而免疫球蛋白值除IgM值略高外，其餘結果正常。血、尿等細胞培養皆為陰性。患者作胸部CT檢查後接受開胸探查術，病理切片檢視為一混合細胞型的Hodgkin氏病。按病灶所在及臨床症狀顯示病童屬於stage IV(下標B)，故患者接受放射及化學合併治療，目前狀況穩定。在門診追踪治療中。此患者臨床症狀甚不明顯，僅於胸部X光檢查時才發現病灶，故特提出報告，希望醫師們對一般門診發燒的病患，能提高警覺，以儘早發現病灶。

關鍵字

Hodgkin氏淋巴瘤 ； 縱隔腔腫瘤

並列摘要

A four-year-old male was admitted with a history of intermittent fever, night sweats, and body weight loss of about 1 kg over a one month period. The patient was a normal appearing child of moderate development. Except for mild tachypnea, no local lymph node enlargement or skin pathologic changes were found. A clear lobulated margin tumor mass located to the right of the mediastinum was found on the patient's chest X-ray. Other tests revealed increasing eosinophils in peripheral blood, an increasing AIk. P. level (196 u/I) on the SMA, and a normal value of immunoglobulin in electrophoresis. Urine and blood cultrues showed no growth after one week. Following chest CT examination, exploratory thoracotomy was performed and the mass removed. The pathologic findings showed a mixed cellular type of Hodgkin's disease. The disease belonged to stage IVB as the tumor mass had invaded lung tissue. The patient received combined radio and chemotherapy, and remains on OPD treatment and follow-up.

並列關鍵字

Hodgkin's Lymphoma