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一位出生于长崎的64岁女性,出现右颈部和颌下淋巴结肿大.经活检(并用免疫细胞化学和间接免疫荧光法确定)和分期检查,诊断为弥散型B细胞型非何杰金氏淋巴瘤(NHL)Ⅳ期。经用长春新碱,环磷酰胺、强的松龙、阿霉素和6-巯基嘌呤治疗后获得完全缓解。9年后,左后颈部淋巴结肿大,并发现皮疹和白细胞增高,其中85%为异常细胞,核呈分叶和卷曲优畸形,还有贫血、血小板减少和GOT、GPT增高。骨髓增生低下,有10.5%的异常淋巴细胞。免疫组化检查证实皮肤浸润细胞都是T细胞,外周血淋巴细胞为辅助/诱导T淋巴细胞亚群.ATLA抗体滴度为1:160,外周血淋巴细胞Southern。blot分析证明有HTLV前病毒DNA的单克隆整合,
A 64-year-old woman born in Nagasaki developed swelling of the right neck and submandibular lymph nodes. His biopsy (and determination by immunocytochemistry and indirect immunofluorescence) and staging were performed to diagnose diffuse B-cell non-Hodgkin. Gold lymphoma (NHL) stage IV. Complete remission was achieved after treatment with vincristine, cyclophosphamide, prednisolone, doxorubicin, and 6-mercaptopurine. Nine years later, lymph nodes were enlarged in the left posterior cervical region and rashes and white blood cells were found to be elevated. Eighty-five percent of them were abnormal cells, and the nucleus was lobulated and predominantly curled. There was also anemia, thrombocytopenia, and increased GOT and GPT. Low myeloid hyperplasia, with 10.5% of abnormal lymphocytes. Immunohistochemical examination confirmed that the skin infiltrating cells were T cells and peripheral blood lymphocytes were assisted/induced T lymphocyte subsets. ATLA antibody titer was 1:160, and peripheral blood lymphocytes were Southern. Blot analysis demonstrated the monoclonal integration of HTLV proviral DNA,