중추신경계와 폐를 침범한 말초 T세포 림프종 1예

Abstract

말초형 T세포 림프종은 B세포 림프종에 비해 림프절 외 침범이 많고 항암요법에 대한 반응이 낮아서 예후가 불량한 것으로 알려져 있다. 특히 비특정 말초 T세포 림프종은 폐나 신경계의 침범이 매우 드물고 표준 치료가 정립되어 있지 않다. 이 때문에 환자별로 치료자의 판단에 따라 적절한 치료전략이 세워져야 한다. 본 증례는 폐와 신경계를 침범한 비특정 말초 T세포 림프종의 1예로 IMEP 복합항암화학요법과 척추강 내 항암화학요법으로 관해 유도에 성공하였고, 관해 후 치료로써 고용량 항암화학요법 및 자가조혈모세포이식을 시도한 경우이다.

Mature T-cell non-Hodgkin’s lymphoma (NHL) has more frequent extranodal involvement and is less sensitive to chemotherapy than B-cell lymphoma. Peripheral T-cell lymphoma unspecified (PTCL-U) is rarely combined with pulmonary or CNS involvement. We report a case of PTCL-U with lung and CNS involvement that was treated with high-dose chemotherapy followed by autologous stem cell transplantation (ASCT). A 62-year-old man was admitted with right-side weakness and paresthesias, and was diagnosed with PTCL-U after alung biopsy. Successful complete remission was achieved after threecycles of IMEP (ifosfamide, methotrexate, etoposide, and prednisone) chemotherapywith concurrent intrathecal chemotherapy and subsequent high-dose chemotherapy with ASCT to treat potential advanced stage PTCL-U. The non-anthracycline-containing IMEP regimen can be effective for PTCL-U, especially in cases with CNS involvement.