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淋巴瘤是淋巴网状组织的恶性肿瘤,随着病情的发展,常侵犯任何器官和组织,但引起骨髓重度纤维化临床上少见,现将我院收治的1例报告如下:患者,男,35岁,农民,因头晕、乏力、发热20天,颈部肿块1周于1994年3月14日入院.患者既往健康.检查:39.2℃,神清,中度贫血外观,全身皮肤及粘膜无出血点及紫癜,颈部、腋窝、腹股沟均可触及数个鸽蛋及黄豆大的淋巴结,无触痛,境界清楚,质偏硬,与周围组织无粘连,胸骨无压痛,心肺(一),腹软,肝脏在右肋缘下3cm,剑突下5cm,质中,无触痛,脾脏肿大平脐,有触痛,质偏硬,NS(一).周围血象:Hb70g/L,WBC 5.2×10~9/L,N80,L20,BPC70×10~9/L.两侧髂后3次穿刺均干抽.后做骨髓活检.病理报告:骨髓重度纤维化.颈部淋巴结活检病理报告:非霍奇金淋巴瘤(T细胞性).T细胞亚群:CD_3 48.9%、CD_4 44.6%,CD_8 22.5%.胸片报告:中上纵隔影增宽,肺门影增宽呈多个团块状影,考虑为纵隔淋巴瘤.入院确诊为:非霍奇金淋巴瘤Ⅳ期并重度骨髓纤维化.给予COBP方案1疗程,患者临床症状明显好转,无发热,全身浅表淋巴结明显缩小,脾脏缩至左肋缘下1cm,目前仍在治疗中.骨髓纤维化是一种骨髓增殖性疾病,可原发,也可继发于其它疾病.
Lymphoma is a malignant tumor of lymphoid reticular tissue. As the disease progresses, it often invades any organs and tissues. However, severe bone marrow fibrosis is rarely seen in clinical practice. One case reported in our hospital is reported as follows: patient, male, 35 Years old, farmer, due to dizziness, fatigue, fever for 20 days, neck mass was admitted to hospital on March 14, 1994 for 1 week. The patient was previously healthy. Check: 39.2°C, Shen Qing, moderate anemia appearance, no bleeding of the whole body skin and mucous membranes Spots and asters, neck, axillary, groin can touch several large pigeon eggs and soy lymph nodes, no tenderness, realm clear, qualitative hard, no adhesion with the surrounding tissue, no tenderness of the sternum, heart and lungs (a), abdomen Soft, liver 3cm below the right costal margin, 5cm below xiphoid, qualitative, no tenderness, splenomegaly flat umbilicus, tenderness, hard, NS (a). Peripheral blood: Hb70g/L, WBC 5.2 × 10~9/L, N80, L20, BPC70×10~9/L. Three punctures were performed on both sides of the puncture. After bone marrow biopsy was performed. Pathology report: Severe bone marrow fibrosis. Pathological report of cervical lymph node biopsy: non- Hodgkin’s lymphoma (T-cell). T-cell subsets: CD_3 48.9%, CD_4 44.6%, CD_8 22.5%. Chest radiology: mediastinal mediastinum image widened, hilar image broadened in multiple clumps Shadow, considered as Lymphoma. Admitted to hospital for diagnosis: non-Hodgkin’s lymphoma stage IV and severe myelofibrosis. Given COBP regimen 1 course, the patient’s clinical symptoms improved significantly, no fever, the body superficial lymph nodes significantly reduced, the spleen reduced to the left costal margin The next 1cm is still under treatment. Bone marrow fibrosis is a myeloproliferative disease that can be primary or secondary to other diseases.