Diffuse Large B-cell Lymphoma Presenting with Massive Pleural Effusion

瀰漫性大型B細胞淋巴癌合併大量胸水病例報告

林祈邑(Chi-Yi Lin) ； 吳俊漢(Chun-Han Wu) ； 黃俊雄(Chun-Hsiung Huang) ； 黃才旺(Tsai-Wang Huang)

《胸腔醫學》 32卷5期 (2017/10) Pp. 226-231

摘要

Malignant lymphoma with pleural involvement affects 16% of patients with non- Hodgkin lymphoma during disease progression. Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma and accounts for approximately 24% of all cases. For lymphoma specified by site, primary effusion lymphoma is defined as lymphoid proliferations in the body cavities without extracavitary tumor masses, and accounts for 7% of all lymphomas. Primary effusion lymphoma is usually found in the pleural, peritoneal, and pericardial cavities, and even in the cerebrospinal fluid, and is universally associated with human herpes virus-8. We present the case of a 57-year-old man with diffuse large B-cell lymphoma with extranodal sites of involvement and pleural effusion who was negative for human immunodeficiency virus infection and not a recipient of an organ transplant. However, serology revealed he was positive for hepatitis C virus infection. The malignant pleural effusion was in complete remission after 3 cycles of R-CHOP chemotherapy.

關鍵字

diffuse large B-cell lymphoma ； non-Hodgkin lymphoma ； primary effusion lymphoma

並列摘要

惡性淋巴癌病肋膜侵犯約占非何杰金氏淋巴癌病患的百分之16。瀰漫性大型B細胞淋巴癌是非何杰金氏淋巴癌中最常見的次分類，約占百分之24。根據淋巴癌原發的部位，原發積液淋巴瘤定義為惡性淋巴增生在體腔部位而沒有體腔外的腫塊，發生率約占總淋巴癌的百分之7。常見侵犯部位在肋膜腔、腹膜腔、心包膜腔及甚至在腦脊髓液中，並且與人類疱疹病毒第8型感染有密切相關。我們報告一例57歲男性診斷為瀰漫性大型B細胞淋巴癌合併淋巴結外侵犯及肋膜積水，本身無人類免疫缺乏病毒感染且非器官移植的接受者。然而，血清學上指出病人有C型肝炎病毒感染。在第三次輔助性化學治療（R-CHOP）結束後他的肋膜積液的症狀得到完全緩解。

並列關鍵字

瀰漫性大型B細胞淋巴癌 ； 非何杰金氏淋巴癌 ； 原發積液淋巴瘤