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病例35-2019:一名患全血细胞减少和皮疹的66岁男性
Case 35-2019 — A 66-Year-Old Man with Pancytopenia and Rash


Marcela V. Maus ... 肿瘤 • 2019.11.14

病例陈述


Joshua Salvi医师(内科):1例有全血细胞减少病史的66岁男性患者在冬季被转到本院,接受关于全血细胞减少和皮疹的检查。

患者既往体健,但此次入院前1年开始出现间歇性发热。入院前约3个月,发热频率和严重程度增加,体温最高38.3℃,并且同时发生寒战。手臂和腿部出现散在的丘疹;皮损最初为深红斑,数日后颜色变浅,出现脱皮。患者不伴有瘙痒,且发热与皮损加重的时间不重合。





作者信息

Marcela V. Maus, M.D., Ph.D., Mark B. Leick, M.D., Kristine M. Cornejo, M.D., and Valentina Nardi, M.D.
From the Departments of Medicine (M.V.M., M.B.L.) and Pathology (K.M.C., V.N.), Massachusetts General Hospital, and the Departments of Medicine (M.V.M., M.B.L.) and Pathology (K.M.C., V.N.), Harvard Medical School — both in Boston.

 

参考文献

1. Otrock ZK, Hock KG, Riley SB, de Witte T, Eby CS, Scott MG. Elevated serum ferritin is not specific for hemophagocytic lymphohistiocytosis. Ann Hematol 2017;96:1667-1672.

2. Bergsten E, Horne A, Aricó M, et al. Confirmed efficacy of etoposide and dexamethasone in HLH treatment: long-term results of the cooperative HLH-2004 study. Blood 2017;130:2728-2738.

3. Henter J-I, Horne A, Aricó M, et al. HLH-2004: diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer 2007;48:124-131.

4. Hejblum G, Lambotte O, Galicier L, et al. A Web-based Delphi study for eliciting helpful criteria in the positive diagnosis of hemophagocytic syndrome in adult patients. PLoS One 2014;9(4):e94024-e94024.

5. Rivière S, Galicier L, Coppo P, et al. Reactive hemophagocytic syndrome in adults: a retrospective analysis of 162 patients. Am J Med 2014;127:1118-1125.

6. Anderson T, Chabner BA, Young RC, et al. Malignant lymphoma. 1. The histology and staging of 473 patients at the National Cancer Institute. Cancer 1982;50:2699-2707.

7. Elstrom R, Guan L, Baker G, et al. Utility of FDG-PET scanning in lymphoma by WHO classification. Blood 2003;101:3875-3876.

8. Weiler-Sagie M, Bushelev O, Epelbaum R, et al. (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med 2010;51:25-30.

9. Willemze R, Jansen PM, Cerroni L, et al. Subcutaneous panniculitis-like T-cell lymphoma: definition, classification, and prognostic factors: an EORTC Cutaneous Lymphoma Group Study of 83 cases. Blood 2008;111:838-845.

10. Gallardo F, Pujol RM. Subcutaneous panniculitic-like T-cell lymphoma and other primary cutaneous lymphomas with prominent subcutaneous tissue involvement. Dermatol Clin 2008;26:529-540.

11. Rodríguez-Pinilla SM, Ortiz-Romero PL, Monsalvez V, et al. TCR-γ expression in primary cutaneous T-cell lymphomas. Am J Surg Pathol 2013;37:375-384.

12. Horwitz S, O’Connor OA, Pro B, et al. Brentuximab vedotin with chemotherapy for CD30-positive peripheral T-cell lymphoma (ECHELON-2): a global, double-blind, randomised, phase 3 trial. Lancet 2019;393:229-240.

13. Giordano M, Roncagalli R, Bourdely P, et al. The tumor necrosis factor alpha-induced protein 3 (TNFAIP3, A20) imposes a brake on antitumor activity of CD8 T cells. Proc Natl Acad Sci U S A 2014;111:11115-11120.

14. Zhou Q, Wang H, Schwartz DM, et al. Loss-of-function mutations in TNFAIP3 leading to A20 haploinsufficiency cause an early-onset autoinflammatory disease. Nat Genet 2016;48:67-73.

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