一名28岁的男子出现在我们的医院,左颈部和双侧腋下有一个快速增长的结节,有体重减轻的历史。自两年前以来,他一直在她的右宫颈结节,并进行了FNAC并诊断为肺外结核(EPTB),在左颈椎检查;肿块大小9厘米×7厘米,mobile,耳前淋巴结肿大3cmx3cm,淋巴结病锁骨上大小1cmx0,5cm。双侧淋巴结肿大Axila大小4cmx4cmx2xcm移动。其他体检是正常的。实验室试验Hb10,4d/dL,WBC14.250/mm3,LED78毫米/小时,D-二聚体1,81ug/mL,纤维蛋白原452mg/dL。HIV测试无反应性。HbsAg和HCV检测阴性。胸部CT扫描:前纵隔淋巴结扩大,直径0f2.9cm,右气管旁直径为1,2cm和1,1cm,和直径为1,3厘米的右肺门周围。和左肺门直径0,9。脾脏低密度病变测量2,3cm×1,6cm。患者接受了病理活检和免疫组织化学(IHC)活检,CD20+。CD3-,CD30+CD79a+,MUM1+,Ki6780-90%+,CD15-,BCL6+和BCL2+。对这个病人来说,我们开始了R-CHOP方案(利妥昔单抗375mg/m2(d1),环磷酰胺750mg/m2(d1),阿霉素50mg/m2(d1),长春碱1,2mg/m2(d1)和1泼尼松100mg(d1-d5)。我们介绍了PMGZL患者已获得完全缓解,尤其是化疗R-CHOP方案。
A 28 -year-old man presented to our hospital with a rapidly growing nodule in the left cervical and bilateral axilla with a history of loss of weight. He has been experiencing a nodule in her right cervical since two years ago and had done FNAC and diagnosed extrapulmonary tuberculosis (EPTB), on Examination at left cervical colli; mass size 9cm x 7 cm, mobile, Lymphadenopathy at pre auricular size 3cm x 3cm, lymphadenopathy supraclavicular size 1cm x 0,5 cm. bilateral lymphadenopathy Axila size 4cmx 4cmx 2xcm mobile. The other physical exam was normal. Laboratory test Hb 10,4 d/dL, WBC 14.250/ mm3, LED 78 mm/hours, D-dimer 1,81 ug/mL, Fibrinogen 452 mg/dL. HIV test non-reactive. HbsAg and HCV test negative. CT-Scan Thorax: Enlarged Anterior mediastinal Lymph node with a diameter 0f 2.9 cm, right paratracheal with a diameter of 1,2cm and 1,1 cm, and right perihilar with a diameter of 1,3 cm. and the left perihilar diameter 0,9. And hypodense lesion of the spleen measuring 2,3cm x 1,6 cm. The patient underwent a biopsy with pathology biopsy and immunohistochemistry (IHC), CD 20+. CD 3-, CD 30+ CD79a +, MUM1 +, Ki67 80-90% +, CD15-, BCL6+ and BCL 2+. For this patient, we started an R-CHOP regimen (Rituximab 375 mg/m2 (d1), Cyclophopamid 750 mg/m2 (d1), Doxorubicin 50 mg/m2 (d1), Vincristine1,2 mg/m2 (d1) and 1 Prednisone 100 mg (d1-d5). We presented the patient with PMGZL has achieved a complete response, especially with chemotherapy R-CHOP regimens.