目的 回顾性分析肝移植术后淋巴组织增殖性疾病的临床症状、诊治经验和预后.方法 1例67岁女性,肝移植术后12个月出现发热和腹泻,CT检查发现肝门部及肝实质占位,临床误诊为肝脓肿,抗感染治疗后效果不佳；经过3次病理活检最后确诊为肝移植后淋巴组织增生异常、单克隆源性增殖,给予减少抗排斥药物及局部三维适形放疗DT30Gy/15次.结果 放疗3次体温即降至正常,胆红素逐渐降低；放疗结束后复查CT,病灶明显缩小.结论 减少抗免疫排斥药物和局部放疗对肝移植后淋巴组织增殖性疾病可取得明显近期疗效.%Objective To retrospectively analyze the clinical symptoms, diagnosis, treatment, and prognosis of lymphoproliferative disease after liver transplantation. Methods Diarrhea and fever occurred in a 67-year-old female patient 12 months after liver transplantation. Abdominal CT demonstrated an occupying lesion in hepatic portal and parenchyma which was misdiagnosed as hepatic abscess with a poor outcome after antibiotic treatment. The disease was diagnosed after 3 biopsies and treated with reduced immunosuppressants and local 3- dimensional conformal radiation therapy at total dose of 30Gy, which was given in 15 fractions. Results The body temperature of the patient returned to normal and her bilirubin level decreased after 3 fractions of radiation therapy. CT demonstrated that the lesion became much smaller after radiation therapy. Conclusion Reduced immunosuppressants and local radiotherapy can achieve significant short-term outcome in patients with lymphoproliferative disease after liver transplantation.
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