演題詳細

ポスター / Poster

ポスター 30 (Poster 30) :リンパ腫:AITL・皮膚リンパ腫

print

日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F ロイトンホールABCD)
座長・司会
内田 俊樹 (Toshiki Uchida):1
1:名古屋第二赤十字病院 血液・腫瘍内科
 
前へ戻る

Angioimmunoblastic T-cell lymphoma accompanied by heavy chain disease

演題番号 : PS-1-224

土師 正二郎 (Shojiro Haji):1、喜安 純一 (Junichi Kiyasu):2、立川 義倫 (Yoshimichi Tachikawa):2、油布 祐二 (Yuji Yufu):2、小鶴 三男 (Mitsuo Kozuru):2

1:Department of Hematology, National Kyushu Cancer Center, Japan、2:Department of Hematology, Aso Iizuka Hospital

 

About one third of patients with heavy chain disease (HCD) have associated autoimmune diseases, and some of angioimmunoblastic T-cell lymphoma (AITL) patients autoimmune diseases can be detected. However, AITL accompanied by HCD has not been reported. We report here a rare case of AITL and discuss this case in relation to the literature. A 75-year-old man with a 16-year history of RA had been treated with methotrexate (MTX) and showed little RA activity. A complete blood count showed severe thrombocytopenia (22 × 109/L), and moderate anemia (87 g/L). The plasma soluble interleukin-2 receptor level was 13984 U/ml. His Epstein-Barr virus antibody profile indicated a prior inapparent infection. CT scan showed splenomegaly with splenic infarction and swelling of systemic lymph nodes. Autoimmune hemolytic anemia with positive Coombs` test were seen, but he did not meet any of the diagnostic criteria of collagen diseases except RA. An inguinal lymph node biopsy specimen was morphologically consistent with AITL and MTX-associated lymphoproliferative disorder was suspected. His urine immunofixation electrophoresis showed a specific band for IgG, indicating the production of a monoclonal and incomplete immunoglobulin heavy chain. The diagnosis of HCD was also made. MTX was immediately discontinued but splenomegaly and lymph node swelling remained. The patient received palliative chemotherapy of etoposide and sobuzoxane due to poor performance status. After two courses of chemotherapy, his urine immunoglobulin heavy chain disappeared and he is doing well at 4-month follow up.

前へ戻る