根據之前的文獻報告,罹患慢性淋巴性白血病/小淋巴細胞淋巴瘤的病人,很容易得到第二個癌症。這是因為細胞免疫和體液免疫受損的緣故。我們這次舉一位77歲男性,被診斷為轉移性膀胱移行上皮細胞癌病人,因而接受健澤(gemcitabin)和卡鉑(carboplatin)三個療程,但是效果不彰。右側頸部淋巴結做了切片檢查,結果是乙型小細胞淋巴瘤。經由骨髓切片和流式細胞計數確定為慢性淋巴性白血病。病人接受全膀胱切除和後腹腔淋巴結的切除,並且得到兩種腫瘤較正確的分期。我們在此舉這個難治的膀胱移行上皮細胞癌,被偶然發現合併小淋巴細胞淋巴瘤於同一個膀胱和淋巴結。
Patients who have small lymphocytic lymphoma have a higher risk of developing a second cancer. Impaired humoral and cellular immunity may be the cause of the secondary malignancy. A 77-year-old man had been treated for metastatic bladder transitional cell carcinoma with 3 courses of gemcitabine and carboplatin, but in vain. The biopsy of the neck lymph node showed small B cell lymphoma. After bone marrow biopsy and flow cytometry, small lymphocytic lymphoma was suspected. Total cystectomy and retroperitoneal lymphadenectomy were performed for the accurate staging of both malignant diseases. We herein report this case of refractory bladder transitional cell carcinoma in which a concomitant small lymphocytic lymphoma was incidentally found.
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