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外文期刊>Clinical Medicine Insights: Blood Disorders
>A Clinical Triad with Fatal Implications: Recrudescent Diffuse Large B-cell Non-Hodgkin Lymphoma Presenting in the Leukemic Phase with an Elevated Serum Lactic Acid Level and Dysregulation of the TP53 Tumor Suppressor Gene – A Case Report and Literature Review
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A Clinical Triad with Fatal Implications: Recrudescent Diffuse Large B-cell Non-Hodgkin Lymphoma Presenting in the Leukemic Phase with an Elevated Serum Lactic Acid Level and Dysregulation of the TP53 Tumor Suppressor Gene – A Case Report and Literature Review
Despite representing 30% to 40% of newly diagnosed cases of adult non-Hodgkin lymphoma, diffuse large B-cell lymphoma (DLBCL) rarely presents (1) in the leukemic phase (2) with dysregulation of the TP53 tumor suppressor gene and (3) an elevated serum lactic acid level. In this case report and literature review, we highlight this unfortunate triad of poor prognostic features associated with an aggressive and fatal clinical course in a 53-year-old man with recrudescent DLBCL. A leukemic presentation of de novo or relapsed DLBCL is rare and may be related to differential expressions of adhesion molecules on cell surfaces. In addition, TP53 gene mutations are present in approximately 20% to 25% of DLBCL cases and foreshadow worse clinical outcomes. Finally, an elevated serum lactic acid level in DLBCL that is not clearly associated with sepsis syndrome is a poor prognostic factor for survival and manifests as type B lactic acidosis through the Warburg effect.
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机译:尽管代表了新诊断的成人非霍格金淋巴瘤病例的30%至40%,但弥漫性大B细胞淋巴瘤(DLBCL)很少在白血病阶段(2)中呈(1)呈现出TP53肿瘤抑制基因的失调和(3 )血清乳酸水平升高。在本案的报告和文献综述中,我们突出了与经济荧光DLBCL的53岁男性的侵略性和致命的临床课程相关的难以困扰的预后特征的不良三合会。 De Novo或复发DLBCL的白血病呈呈稀有,并且可能与细胞表面上粘附分子的差异表达有关。此外,TP53基因突变在约20%至25%的DLBCL病例中存在,并且预示着更差的临床结果。最后,DLBCL中的血清乳酸水平升高,与败血症综合征无明显相关的血清乳酸水平是通过Warburg效应作为B型乳酸中毒的较差的预后因素。
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