HIV 감염인에서 발생한 순차적 림프종 1예
A Case of Sequential Lymphoma in an Human Immunodeficiency Virus-Infected Patient
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초록
두 개의 서로 다른 조직형의 악성 림프종이 한 사람에게서 발생되는 것은 매우 드물다. 순차적 림프종이란 두 가지조직형의 림프종이 한 사람에게서 시간차를 두고 발생되는것을 말한다. 47세 HIV 감염인이 혼합세포형 호지킨 림프종을 진단 받고 ABVD 복합항암화학요법을 시행하였다. 복합항암화학요법 6차 시행 후 복부 컴퓨터 단층촬영에서 여러 개의간 내 병변이 관찰되었으며 경피적 침생검술과 PCR-SSCP 결과 간비장 T-세포 림프종으로 진단되었다. 전신상태 악화로항암화학요법을 시행하지 못했으며 간비장 T-세포 림프종 진단 3개월 만에 사망하였다. 본 환자는 HIV 감염인에서 호지킨 림프종 발병 후에 간비장 T-세포 림프종이 발병한 순차적림프종의 국내 첫 사례로 문헌고찰과 함께 보고하는 바이다.
Abstract
Rarely, two different histological types of lymphoma develop in the same person. Sequential lymphoma is defined as two differenttypes of lymphoma occurring in the same person sequentially. A 47-year-old patient with human immunodeficiency virus (HIV)infection who had been diagnosed with mixed cellularity Hodgkin’s lymphoma was treated with adriamycin, bleomycin, vinblastine,and dacarbazine combination chemotherapy. After six cycles of chemotherapy, abdominal computed tomography showed multipleliver masses. A percutaneous needle biopsy of the liver and polymerase chain reaction single-strand conformation polymorphismrevealed hepatosplenic T-cell lymphoma. The patient died 3 months after the diagnosis of hepatosplenic T-celllymphoma. To our knowledge, this is the first case of the sequential development of hepatosplenic T-cell lymphoma after Hodgkin’slymphoma in a Korean HIV-infected patient.
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