Læknaneminn - 01.01.2017, Blaðsíða 63

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Mat á horfum sjúklinga sem greinast með PMBL eftir sömu leiðum og
þeirra sem greinast með önnur stóreitilfrumuæxli af B­frumugerð getur
verið villandi. Þar sem sjúklingar sem greinast með PMBL eru yfirleitt
yngri en þeir sem greinast með önnur eitilfrumuæxli og sjúkdómurinn
er yfirleitt bundinn við miðmæti getur stigagjöfin haft takmarkað
forspárgildi. Horfur sjúklinga með PMBL fara að mestu eftir almennu
ástandi þeirra við greiningu og svari við fyrstu krabbameinsmeðferð.
Rannsóknir hafa sýnt fram á svipaðar horfur sjúklinga með PMBL og
önnur ekki­Hodgkins eitilfrumuæxli19,21.
Í tilfellinu sem hér um ræðir reyndist æxlið vera stóreitilfrumuæxli af
B­frumugerð. Þrátt fyrir aldur sjúklings og staðsetningu sjúk dómsins
uppfyllti vefjagerðin ekki skilyrði PMBL, þar sem hvorki voru merki
um bandvefsaukningu í æxlinu né tjáningu á CD30, CD45 eða bcl­2.
Samantekt
Hér var lýst tilfelli konu sem greindist með fyrirferðarmikinn æxlis­
vöxt í miðmæti viku eftir fæðingu barns. Æxlið reyndist vera frumkomið
stóreitilfrumuæxli af B­frumugerð í miðmæti af stigi IIB. Meðferð með
R­CHOP var hafin strax í kjölfar greiningar og hefur sjúklingurinn
sýnt fulla meðferðarsvörun.
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