原发性纵隔大B细胞淋巴瘤(PMLBCL)是起源于胸腺B细胞的侵袭性肿瘤。临床上,它表现出咳嗽等一般症状,胸痛和呼吸困难。虽然这些症状并不具体,它们严重到足以揭示疾病。我们报告了一个25岁男子的尸检案例,最近有咳嗽和呼吸困难的病史,为此,他两次咨询了急诊科,没有做出任何诊断。他向应急小组介绍,突然出现呼吸困难,然后失去意识。他不久后被宣布死亡,有人要求进行法医尸检。在外部检查中,尸体上没有发现创伤性损伤,一个重要的脸和耳朵发紫,是,然而,已找到。尸检时,发现纵隔肿块,尺寸为19厘米×25厘米,重600克,延伸到舌骨下区域和胸廓并浸润心包。气管粘膜坏死,淋巴结部分阻塞。根据病理和免疫组织化学结果,怀疑诊断为原发性纵隔大B细胞淋巴瘤。死亡原因最终归因于该肿瘤导致的呼吸衰竭。
Primary mediastinal large B-cell lymphoma (PMLBCL) is an aggressive tumor originating from thymic B-cells. Clinically, it presents with general signs such as cough, chest pain and dyspnea. Although these symptoms are not specific, they are severe enough to reveal the disease. We report an autopsy
case of a 25-year-old man, with a recent past history of cough and dyspnea, for which he consulted twice the emergency department and no diagnosis was made. He presented to the Emergency Unit, with a sudden onset of a dyspnea followed by a loss of consciousness. He was shortly declared dead after, a medico-legal autopsy was requested. On external examination, no traumatic lesions on the body were found, an important cyanosis of the face and ears, was, however, found. On autopsy, a mediastinal mass was found, measuring 19 cm × 25 cm and weighing 600 g, extending to the infra-hyoid region and to the thoracic cage and infiltrating the pericardium. Trachea had a necrotic mucosa with a partially obstructive lymph node mass. The diagnosis of a primary mediastinal large B-cell lymphoma was suspected based on pathological and immunohistochemical findings. The cause of death was finally attributed to respiratory failure due to this tumor.