病例報告: 陰囊水腫術後診斷血管内大B细胞淋巴瘤合併吞噬症候群
鄭隆峯1、陳逸軒1,2、余家政1,2,3、吳東霖1
1高雄榮民總醫院外科部泌尿外科
2國防醫學中心三軍總醫院外科部泌尿外科
3大仁科技大學藥學系
Case report: Hydrocelectomy-diagnosed intravascular large b-cell lymphoma with hemophagocytosis
Lung-Feng Cheng1、I-Hsuan Chen1,2、Chia-Cheng Yu1,2,3、Tong-Lin Wu1,3
1 Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital
2 Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center
3 Department of Pharmacy, Tajen University
Abstract:
Intravascular large B-cell lymphoma (IVBL) is a diffuse large B-cell lymphoma featuring by the presence of lymphoma cells exclusively in the lumen of small blood vessels particularly capillaries. It is a rare extranodal subtype of diffuse large B-cell lymphoma. Clinical manifestations include constitutional symptoms, skin lesions, stroke, focal neurologic deficits, dyspnea, hepatosplenomegaly and splenic infarction.
This 68-year-old gentleman was initially diagnosed as hemophagocytosis and received systemic chemotherapy with VP-16 and Cyclosporine prescribed by our medical oncologist. After 19-month treatment, he presented with bilateral scrotal swelling and thickening and hardening of the skin with engorged superficial veins and non-pitting edema on both legs. The scrotal ultrasonography showed bilateral hydroceles, without abnormal testes. Bilateral hydrocelectomy was performed and the pathology report revealed intravascular large B-cell lymphoma. Besides, the skin biopsy of bilateral thighs also demonstrated the same result. In this report, the clinical, cytological, histological, and immunohistochemical features of this case are described, and a review of the literature about this neoplasm is presented.