用R-Hyper-CVAD成功治疗伪装成中风的血管内大b细胞淋巴瘤

IF 0.7 Q4 HEMATOLOGY Leukemia Research Reports Pub Date : 2023-11-27 DOI:10.1016/j.lrr.2023.100401

Christopher Popiolek , Kanchan Gupta , Mallorie L. Huff , Ranju Gupta

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摘要

血管内大B细胞淋巴瘤(IVLBCL)极为罕见且难以诊断。我们描述一个病例IVLBCL在一个56岁的男性，这是确定后反复中风。行右侧部分肾切除术，确诊为肾嗜瘤细胞瘤和肾上皮细胞癌。化疗开始于标准的R-Hyper-CVAD，包括鞘内甲氨蝶呤和阿糖胞苷。R-CHOP在很大程度上被认为是IVLBCL的治疗选择，然而该方案中的低剂量化疗不会像R-Hyper-CVAD那样穿过血脑屏障。患者在完成治疗后获得完全缓解，并在诊断后保持缓解5年。

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Intravascular large B-cell lymphoma masquerading as stroke successfully treated with R-Hyper-CVAD

Intravascular large B cell lymphoma (IVLBCL) is exceedingly rare and difficult to diagnose. We describe a case of IVLBCL in a 56-year-old male which was identified after recurrent strokes. Right partial nephrectomy was then performed which demonstrated renal oncocytoma and IVLBCL. Chemotherapy was initiated with standard R-Hyper-CVAD which included intrathecal methotrexate and cytarabine. R-CHOP is largely considered the treatment of choice in IVLBCL, however low doses of chemotherapy in this regimen do not cross the blood brain barrier like in R-Hyper-CVAD. The patient achieved complete remission after completion of treatment and has remained in remission for 5 years after diagnosis.

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