Clara María Cascio Baccanelli, Andrea Melissa Sian, Pedro Vicente Uad, Jeremias Goransky Patiño
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引用次数: 0
摘要
继发于非霍奇金淋巴瘤的胆管阻塞极为罕见。因此,我们在此介绍一位 63 岁女性患者的病例,她因黄疸、深色尿液、白细胞减少和乏力而就医。化验结果显示为胆汁淤积型,超声波检查发现肝内外胆管扩张,因此要求进行胆管共振检查。超声波显示肝总管扩张,边界不清,并伴有狭窄。最初怀疑是克拉茨皮瘤,为此进行了活检,结果显示胆管原发肿瘤为双表达大 B 细胞淋巴瘤浸润。患者接受了 R-CHOP 方案(利妥昔单抗、环磷酰胺、多柔比星、长春新碱、泼尼松)化疗,病情得到缓解。由于胆管炎持续发作,她接受了 Roux-en-Y 肝空肠吻合术和胆道重建术。该病例凸显了胆管大 B 细胞非霍奇金淋巴瘤的罕见性,并强调了活检对有效治疗的重要性,同时结合化疗治疗基础疾病和手术治疗梗阻性并发症。
[Non-Hodgkin large B-cell lymphoma of the bile duct mimicking a Klatskin tumor: case report].
The obstruction of the bile duct secondary to non-Hodgkin lymphoma is extremely rare. That's why we present the case of a 63-year-old female patient who sought medical attention due to jaundice, dark urine, acholia, and weakness. Laboratory results showed a cholestatic pattern, and an ultrasound revealed dilation of the intra and extrahepatic bile ducts, for which a cholangio resonance was ordered. It showed an expansive formation with ill-defined borders compromising the common hepatic duct associated with its stenosis. The initial suspicion was a Klatskin tumor, for which a biopsy was performed, which reported infiltration of a double expressor large B-cell lymphoma as a primary neoplasm of the bile duct. The patient underwent chemotherapy treatment with R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and went into remission. Due to continuous episodes of cholangitis, a Roux-en-Y hepatic jejunal anastomosis with biliary tract reconstruction was performed. Currently, she remains in remission, seven years after the diagnosis.
This case highlights the rarity of large B-cell non-Hodgkin lymphoma in the bile duct and emphasizes the importance of biopsy for effective treatment, combining chemotherapy for the underlying disease and surgery for obstructive complications.
期刊介绍:
The Journal of the Faculty of Medical Sciences is a scientific publication of the Secretariat of Science and Technology of the Faculty of Medical Sciences of the National University of Cordoba. Its objective is to disseminate and promote research work related to Medical and Biological Sciences. It publishes scientific works of national and international professionals on different topics related to health sciences from the field of medicine, nursing, kinesiology, diagnostic imaging, phonoaudiology, nutrition, public health, chemical sciences, dentistry and related.