肺原发性非霍奇金淋巴瘤临床及病理特点观察.docVIP

肺原发性非霍奇金淋巴瘤临床及病理特点观察 目的探讨原发性肺非霍奇 金淋巴瘤的临床病理特点、影像学特点 及治疗方法。方法收集温州医科大学附 属第一医院2011年?2015年收治的5 例经病理确诊的原发性肺非霍奇金淋巴 瘤患者的临床表现、诊断手段、病理类 型以及预后。结果5例原发性肺非霍奇 金淋巴瘤患者中，男性5例，女性0例， 年龄35?78岁，平均（60.4±16.6）岁， 原发性肺非霍奇金淋巴瘤（PPNHL）患者 没有特异的临床症状及影像学表现，Ann Arbor分期均为IE期，病理学表现以B 细胞淋巴瘤（4/5）多见，确诊主要依靠 经皮肺穿刺粗针活检及支气管镜下活检 而获得病理依据，治疗上多采用CHOP 联合或不联合利炎昔单抗方案治疗，病 情达到缓解。结论PPNHL非常罕见，临 床及影像学表现无特异性，诊断较为困 难，极易误诊、漏诊。PPNHL的确诊依 靠病理活检及免疫组织化学染色分型， 纤维支气镜及经皮肺穿刺活检是病灶取 材可靠的手段。治疗上采用以化疗为主 的综合治疗，必要时辅以放疗、生物治 疗。 关键词：肺肿瘤；淋巴瘤；非霍奇 金；回顾性研宄 Investigation of Clinical and Pathological Features of Primary Pulmonary Non-Hodgkins Lymphoma WU Pei-liang, WANG Qi-ping, YAO DAN, HUANG Xiao-ying (Key Laboratory of Heart and Lung， Pulmonary Division of The First Affiliated Hospital，Wenzhou Medical University， Wenzhou 325000，Zhejiang, China) Abstract： Objective To explore the clinical and pathological features， treatment and prognosis of primary pulmonary non-Hodgkin1 s lymphoma (PPNHL). Methods A retrospective study of PPNHL cases from 2011 to 2015 was performed. All PPNHL cases were confirmed by histopathology. Results The group of five cases were all men， with a median age of 60.4 years (range： 35-78years) . Clinical symptoms and radiographic findings are nonspecific. Three patients had an primary pulmonary mucosa-associated lymphoid tissue lymphoma (MALT)，one had diffuse large B-cell lymphomas (DLBCL) and another had anaplastic large cell lymphoma， ALCL) . A pathological diagnosis was obtained with percutaneous aspiration lung biopsy in four patients and transbronchial needle aspiration in one. The patients were treated with chemotherapy (n=5) . Conclusion PPNHL is very rare， and patients generally have nonspecific symptoms and radiographic findings. Review of references， chemotherapy， biotherapy, or surgery can be used to treat PPNHL. Meanwhile PPNHL appears to have a favorable prognosis. Key words： Lung neoplasms； Lymphoma； Non-Hodgkin； Retrospective studies 原发性肺非霍奇金淋巴瘤(primary pulmonary non-Hodgkin’s lymphoma， PPNHL)是原发于肺内(M侧或双侧)淋 巴