不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Late relapse of extranodal NK/T-cell lymphoma presenting as an adrenal mass with suspected cardiac involvement.
Late relapse of extranodal NK/T-cell lymphoma presenting as an adrenal mass with suspected cardiac involvement.
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结外NK/T细胞淋巴瘤(ENKTCL),鼻型,是一种罕见且侵袭性强的非霍奇金淋巴瘤亚型,常表现为结外受累。虽然复发模式通常涉及鼻腔、肺部或皮肤,但心脏受累较为罕见。我们报告一例50岁晚期患者,患有ENKTCL,鼻型,在化疗和自体干细胞移植后达到完全缓解。他无病生存期6年后出现腹痛和血尿。影像学显示孤立的右侧肾上腺肿块,活检证实为复发性ENKTCL。不久后,偶然发现一个心脏肿块,累及右心房、右心室和心包。虽然不适合活检,但影像学表现出典型的冠状动脉漂浮征,这是心脏淋巴瘤的特征。尽管进行了多种治疗和姑息性努力,由于心脏受累后预后极差,患者仍去世。本病例代表了首例记录在案的复发性ENKTCL表现为心脏受累的病例。
Extranodal natural killer/T-cell lymphoma (ENKTCL), nasal type, is a rare and aggressive subtype of non-Hodgkin's lymphoma that often presents with extranodal involvement. While relapse patterns commonly involve the nasal cavity, lungs or skin, cardiac involvement is rare.
We report a late 50-year-old patient with ENKTCL, nasal type, who achieved complete remission following chemotherapy and autologous stem cell transplantation. He remained disease-free for 6 years before presenting with abdominal pain and haematuria. Imaging revealed an isolated right adrenal mass, confirmed as relapsed ENKTCL on biopsy. Shortly after, an incidental cardiac mass was detected, involving the right atrium, right ventricle and pericardium.
Though not amenable to biopsy, imaging exhibited the classic coronary vessel floating sign, characteristic of cardiac lymphomas. The patient passed away despite multiple therapeutic and palliative efforts due to a very poor prognosis after cardiac involvement. This case represents the first documented case of relapsed ENKTCL presenting with cardiac involvement.
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