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1
題名:Colon Perforation as Initial Manifestation of Post-transplant Lymphoproliferative Disorder Following Kidney Transplant: Report of a Case     (10點)
腎移植後淋巴增生疾病造成結腸穿孔:病例報告
著者:Tung-Cheng Chang(張東風) ;Meng-Kun Tsai(蔡孟昆) ;Wei-Chou Lin(林維洲) ;Po-Huang Lee(李伯皇)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:colon perforation ; post-transplantation lymphoproliferative disorder ; kidney transplantation
刊名:Formosan journal of surgery
卷期:41卷4期(2008.8)
頁碼:158-162
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

一個三十九歲的女性在接受腎臟移植十一個月之後發生了兩天的急性腹症。經過緊急剖腹探查手術之後,發現橫行結腸穿孔以及左側卵巢腫瘤。我們將結腸清瘡之後直接施行橫結腸迴狀造口(loop colostomy of transverse colon)以及左側卵巢切除。病人在術後恢復良好,沒有發生併發生。病理報告診斷?多形性移植後淋巴增生疾病(polymorphic post-transplant lymphoproliferative disorder)。接受了四個療程的抗CD-20抗體治療,並將免疫抑制劑的劑量減半之後,我們發現腫瘤消除,獲得了完全的反應。雖然移植後淋巴增生疾病以大腸穿孔的表現不多,但是發生後對病人會有生命的威脅,所以對於高危險或有懷疑的病人早期的偵測和積極的檢查是很重要的。
A 39 year-old female suffered 2 days of abdominal pain approximately 11 months after cadaveric kidney transplantation. Emergent laparotomy revealed transverse colon ulceration with perforation and left ovarian tumor. Ulceration debridment, loop colostomy of the transverse colon, and left oophorectomy were carried out. Her post-operative course was uncomplicated. The pathological examination revealed polymorphic post-transplant lymphoproliferative disorder. Consequently immunosuppressants were reduced to half of the original dose and anti CD-20 antibody was given to this patient. Complete remission was noted after 4 doses of anti-CD-20 antibody. Colon perforation as the initial presentation of post-transplant lymphoproliferative disorder (PTLD) is unusual. However, early detection is necessary and aggressive investigation should be considered in suspicious cases with a high-risk of PTLD.


    

本卷期目次
Formosan journal of surgery 41卷4期 (2008.8)
Malignant Hemangiopericytoma Presenting as a Huge Retroperitoneal Mass: Report of a Case/ Chien-Cheng ChenChin-Chung TingMeng-Dar LeeMao-Ho LiuChung-Kwe Wang
Hepatocellular Carcinoma Arising from Ectopic Liver: Report of a Case/ Cheng-Ming PengJao-Bin ChenCheng-Chung WuJohn Wang
Colon Perforation as Initial Manifestation of Post-transplant Lymphoproliferative Disorder Following Kidney Transplant: Report of a Case/ Tung-Cheng ChangMeng-Kun TsaiWei-Chou LinPo-Huang LEE
Successful Treatment of Multiple Esophageal Perforations with Delayed Diagnosis in a Cirrhotic Patient: Report of a Case/ Fong-Fong TsaiJang-Ming Lee
Lymph Node Metastasis in Gastric Cancer Indicator or Governor of Survival/ Chew-Wun Wu
Glioblastoma Multiforme of the Cerebellum: Report of Two Cases/ Yuan-Kai LiuChih-Ju ChangJing-Shan Huang
Primary Retroperitoneal Mucinous Cystadenoma: Report of a Case/ Wen-Pin YehMing-Houng Chen
Prosthesis-preserving Mastectomy for Breast Cancer with Previous Augmentation Mammoplasty: Report of Two Cases/ Lan-Yu KungChzoo-Chen YehYiu-Chin LouFang-Ming Liou
Interval Appendectomy after Conservative Treatment of an Appendiceal Mass/ Hung-Wen Lai
Actinomycosis of the Appendix: Report of a Case/ Wei-Chin ChiouChi-Chou HuangShu-Hui HsiehMeng-Cheng Chen
Lymph Node Metastasis in Gastric Cancer Indicator or Governor of Survival/ Chew-Wun Wu
Interval Appendectomy after Conservative Treatment of an Appendiceal Mass/ Hung-Wen Lai
Prosthesis-preserving Mastectomy for Breast Cancer with Previous Augmentation Mammoplasty: Report of Two Cases/ Lan-Yu KungChzoo-Chen YehYiu-Chin LouFang-Ming Liou
Primary Retroperitoneal Mucinous Cystadenoma: Report of a Case/ Wen-Pin YehMing-Houng Chen
Malignant Hemangiopericytoma Presenting as a Huge Retroperitoneal Mass: Report of a Case/ Chien-Cheng ChenChin-Chung TingMeng-Dar LeeMao-Ho LiuChung-Kwe Wang
Colon Perforation as Initial Manifestation of Post-transplant Lymphoproliferative Disorder Following Kidney Transplant: Report of a Case/ Tung-Cheng ChangMeng-Kun TsaiWei-Chou LinPo-Huang Lee
Hepatocellular Carcinoma Arising from Ectopic Liver: Report of a Case/ Cheng-Ming PengJao-Bin ChenCheng-Chung WuJohn Wang
Successful Treatment of Multiple Esophageal Perforations with Delayed Diagnosis in a Cirrhotic Patient: Report of a Case/ Fong-Fong TsaiJang-Ming Lee
Glioblastoma Multiforme of the Cerebellum: Report of Two Cases/ Yuan-Kai LiuChih-Ju ChangJing-Shan Huang
Actinomycosis of the Appendix: Report of a Case/ Wei-Chin ChiouChi-Chou HuangShu-Hui HsiehMeng-Cheng Chen
 
   
 
   

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