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Title: 異時性にマントル細胞リンパ腫を発症した病期Iセミノーマの1例
Other Titles: Metachronous Development of Mantle Cell Lymphoma during Active Surveillance in a Patient with Stage I Testicular Cancer
Authors: 佐野, 啓介  KAKEN_name
木村, 友和  KAKEN_name
河合, 弘二  KAKEN_name
池田, 篤史  KAKEN_name
石塚, 竜太郎  KAKEN_name
神鳥, 周也  KAKEN_name
和久, 夏衣  KAKEN_name
星, 昭夫  KAKEN_name
小島, 崇宏  KAKEN_name
常樂, 晃  KAKEN_name
橋本, 諒典  KAKEN_name
西山, 博之  KAKEN_name
Author's alias: Sano, Keisuke
Kimura, Tomokazu
Kawai, Kouji
Ikeda, Atsushi
Ishitsuka, Ryutaro
Kandori, Shuya
Waku, Natsui
Hoshi, Akio
Kojima, Takahiro
Joraku, Akira
Hashimoto, Ryosuke
Nishiyama, Hiroyuki
Keywords: Testicular cancer
Malignant lymphoma
Issue Date: 31-Dec-2018
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要 = Acta urologica Japonica
Volume: 64
Issue: 12
Start page: 509
End page: 513
Abstract: A 78-year-old man presented with swelling of para-aortic and left iliac lymph nodes (LNs). He had undergone left high orchiectomy 10 years ago. He was diagnosed with stage I seminoma, and was managed with active surveillance. Eight years later, the follow-up computed tomography (CT) revealed para-aortic LN swelling, but the patient refused further treatment. He complained of left lower extremity edema 10 years after orchiectomy. CT showed enlargement of both LNs, especially, diameter of left iliac lymph nodes was up to 9 cm. He was referred to our hospital. LDH was slightly increased to 261 IU/1, but α-fetoprotein, and total and free beta human chorionic gonadotropin were within normal limits. Results of pathological review of the testicular tumor was also seminoma. The treatment with etoposide and cisplatin (EP) was started under the diagnosis of late relapse of seminoma. However, CT after 1 course of EP showed no shrinkage of LN metastases. At this time, soluble interleukin-2 receptor (sIL-2R) was elevated up to 5, 090 U/ml (normal range: 613 U/ml). Needle biopsy from pelvic LN was performed on suspicion of metachronous malignant lymphoma. The pathological diagnosis was mantle cell lymphoma. The patient was transferred to the department of hematology, and treated successfully with rituximab and bendamustine. When LN swelling is seen after long-term active surveillance, there is a possibility of late relapse. However, metachronous malignant lymphoma also should be considered in an elderly patient.
Rights: 許諾条件により本文は2020/01/01に公開
DOI: 10.14989/ActaUrolJap_64_12_509
PubMed ID: 30831668
Appears in Collections:Vol.64 No.12

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