演題詳細

一般口演 / Oral Session

一般口演 100 (Oral Session 100) :節外性B細胞リンパ腫

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日程
2013年10月13日(日)
時間
15:00 - 16:00
会場
第8会場 / Room No.8 (ロイトン札幌 2F ハイネス)
座長・司会
正木 康史 (Yasufumi Masaki):1
1:金沢医科大学 血液免疫内科学
 
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A T-cell-rich effusion mimicking the deterioration of primary effusion lymphoma (PEL)-like lymphoma

演題番号 : OS-3-147

材木 義隆 (Yoshitaka Zaimoku):1,2、青木 剛 (Go Aoki):2、吉田 昌代 (Akiyo Yoshida):1,2、杉盛 千春 (Chiharu Sugimori):2、澤崎 愛子 (Aiko Sawazaki):2、山口 正木 (Masaki Yamaguchi):2、上田 幹夫 (Mikio Ueda):2、中尾 眞二 (Shinji Nakao):1

1:Dept. Hematol., Kanazawa Univ., Japan、2:Dept. Hematol., Ishikawa Pref. Central Hosp., Japan

 

PEL-like lymphoma presents solely as an effusion in the absence of HHV8, and occasionally regresses without chemotherapy. We report 3 cases of PEL-like B-cell lymphoma, which showed transient T-cell-rich effusions mimicking disease progression. All cases were HIV(-) and HHV8(-), and showed complex karyotypes and IGH gene rearrangements.
Case 1: An 84-year-old male presented with pericardial and left pleural effusions. After spontaneous remission following drainage, the left pleural effusion recurred with lymphocytes (3720/μl) consisting of CD8+T cells. The effusion disappeared without treatment.
Case 2: A 78-year-old female had left pleural effusion. Two weeks after the diagnosis, lymphoma cells became undetectable in the residual effusion, which had lymphocytes (4000/μl) mainly consisting of CD4+T cells. The lymphoma recurred with massive left pleural effusion, but after 3 days of continuous drainage, the lymphoma cells again became undetectable. A pleural biopsy revealed pleuritis with predominant CD8+T cells. Her effusion decreased thereafter without treatment.
Case 3: A 63-year-old male presented with pericardial, pleural and peritoneal effusions. He achieved remission after 6 cycles of RCHOP and 1 cycle of CHASER. Six weeks later, the effusions recurred with lymphocytes(170/μl) mainly consisting of CD8+T cells, which disappeared without chemotherapy 16 weeks later.
Reactive effusions may be misdiagnosed as progression of lymphoma and treated inappropriately with chemotherapy. The cellular components of recurring effusions in patients with PEL-like lymphoma should be examined.

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