복수를 동반한 급성 간부전으로 발현된공격성 자연살해세포 림프종 1예
An Aggressive Natural Killer Cell Lymphoma Presenting as Acute Liver Failure with Ascites
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
급성 간부전의 원인은 바이러스성 간염과 약물이 흔하며공격성 NK 세포 림프종은 매우 드문 원인으로 알려져 있다. 저자들은 복수를 동반한 급성 간부전 환자에서 복수 검사와혈액 검사, 영상학적 검사에서 원인이 명확하지 않고 경험적치료에 반응하지 않아 간 생검을 통해서 공격성 NK 세포 림프종을 급성 간부전의 원인으로 진단할 수 있었던 증례를문헌고찰과 함께 보고한다.
Abstract
Acute liver failure (ALF) is a medical emergency triggering an urgent need for liver transplantation. The most common causes of ALF are drug- and virus-associated hepatitis, but hematological malignancies such as an aggressive natural killer cell lymphoma (ANKL) can uncommonly cause ALF. A 50 year-old male presented with ascites, jaundice, and encephalopathy. The ascitic fluid had a serum-ascites albumin gradient of 0.3 g/L, and contained atypical lymphocytes, which were positive for CD3. Computed tomography revealed mild hepatomegaly and multiple nodules in both lobes of the liver. A liver biopsy showed that the liver parenchyma had been infiltrated by malignant lymphoid cells, and exhibited marked sinusoidal dilatation. Immunohistochemically, the lymphoid cells were positive for CD3, CD56, and Epstein-Barr virus-encoded small RNA. The patient was diagnosed with ANKL causing ALF, and died on hospital day 12. This case shows that infiltration of the liver with ANKL can (rarely) cause ALF.
참고문헌 (10)
- Polson J, "American Association for the Study of Liver Disease. AASLD position paper : the management of acute liver failure", Hepatology, 41, pp.1179~1197 (2005)
- Lim YS, "Acute liver failure in Korea : etiology, prognosis and treatment", Korean J Hepatol, 16, pp.5~18 (2010)
- Dellon ES, "Acute liver failure due to natural killer-like T-cell leukemia", lymphoma : a case report and review of the literature, 2006, pp.12, 4089~4092
- Takahashi H, "Successful disease control with L-asparaginase monotherapy for aggressive natural killer cell leukemia with severe hepatic failure", Leuk Lymphoma, 54, pp.662~664 (2013)
- Lee WM, "Acute liver failure", N Engl J Med, 329, pp.1862~1872 (1993)
- Ishida F, "Aggressive natural killer cell leukemia : therapeutic potential of L-asparaginase and allogeneic hematopoietic stem cell transplantation", Cancer Sci, 103, pp.1079~1083 (2012)
- Lima M, "Aggressive mature natural killer cell neoplasms : from epidemiology to diagnosis", Orphanet J Rare Dis, 8, pp.95~ (2013)
- Bihari C, "T-cell lymphoma with raised serum glycoprotein-125(CA-125)and raised ascitic fluid adenosinedeaminase levels initially presenting as ascites : a case report and review of literature", Diagn Cytopathol, 39, pp.770~774 (2011)
- Park JM, "Primary systemic anaplastic large-cell lymphoma presenting as ascites", Korean J Med, 76(Suppl 1), pp.181~185 (2009)
- Buyukberber M, "Non-Hodgkin lymphoma with high adenosine deaminase levels mimicking peritoneal tuberculosis : an unusual presentation", Leuk Lymphoma, 47, pp.565~568 (2006)