Plazmablastni limfom kao redak uzrok subokluzivnih smetnji

  • Snezana Lukic University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Clinical Center of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
  • Sanja Dragasevic Clinical Center of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
  • Sanja Zgradic Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
  • Milena Todorovic University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia
  • Srdjan Djuranovic Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
  • Bosko Andjelic Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Hematology, Clinical Center of Serbia, Belgrade, Serbia
  • Dragan Popovic Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP171025024L
Ključne reči: kronova bolest, dijagnoza, diferencijalna, imunohistohemija, creva, neoplazme, creva, opstrukcija, limfomi, b-krupnoćelijski, difuzni, limfom, plazmablastni, lečenje, ishod

Sažetak


Apstrakt

 

Uvod. Najčešći uzroci subokluzivnih poremećaja u adheziji, Kronova bolest i neoplazme tankog creva. Plazmablastni limfom (PBL) je tip agresivnog difuznog krupnoćelijskog B nehočkinskog limfoma, koji je prvi put opisan u usnoj duplji kod HIV pozitivnih bolesnika. Prikaz bolesnika. U radu je prikazan bolesnik sa PBL tankog creva kao retkim uzrokom subokluzije, bez HIV infekcije i sa negativnom serologijom za hepatitis B, hepatitis C i infekciju Epštajn-Barovim viru­som. Muškarac, star 73 godine, primljen je u naš Centar zbog jednogodišnje istorije bolova u trbuhu, gubitku telesne mase, dijareje (bez krvi), noćnog znojenja i svraba. Bolesniku je urađena kolonoskopija sa terminalnom ileoskopijom, pri kojoj je uzeta biopsija sluznice terminalnog ileuma. Rezultati patohistološkog i imunohistohemijskog ispitivanja su potvrdili dijagnozu PBL. Posle hemioterapije, bolesniku je urađena resekcija ileuma. Rezultat postopera­tivne patohistološke analize je potvrdio dijagnozu PBL. Bolesnik je lečen po protokolu CHOP (ciklofofamid, dok­sorubicin, vinkristin i prednizolon) tokom šest meseci. Fa­talan ishod je nastupio zbog infarkta miokarda. Zaključak. Mada redak i neuobičajen, uzrok subokluzivnih tegoba može biti PBL ileuma. Kod našeg bolesnika krucijalni značaj za dalje lečenje je imala tačna patohistološka verifikacija promena aktiviranih u ileumu.

Reference

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Objavljeno
2021/07/06
Broj časopisa
Vol. 76 Br. 12 (2019): Vojnosanit Pregl
Rubrika
Prikaz bolesnika