R－CHOP联合鞘内化疗治疗原发性乳腺淋巴瘤一例并文献复习

摘要

Objective:To investigate the clinical characteristics,diagnosis and treatment of primary breast lymphoma.Methods:The data were retrospec-tively examined in one typical patient with primary breast lymphoma(PBL) regarding the clinical characteristics,auxiliary examinations and treatment,and relevant literatures were reviewed.Results:Primary breast lymphoma was a clinical rare malignancy,primarily occurring in the breast tissue and character-ized by painless formation breast lumps.Diagnosis of it primarily relied on pathological biopsy,and the pathological type was almost diffuse large B-cell lymphoma.There was no available standard therapy except for surgery,chemotherapy,radiation therapy,or combined therapy.Conclusion:Primary breast diffuse large B lymphoma demonstrates no specific clinical characteristics or imaging properties .Differential diagnosis of it mostly depends on fine needle aspiration biopsy or histological examination of the surgically removed diseased tissue .PET/CT detection may be helpful to comprehensive assessment of the condition before and after the treatment.However,patients benefit little from the surgical procedure.Current recommendations for such entity are simple chemotherapy and/or radiotherapy,yet administration of chemotherapeutic agent rituximab given intrathecally can help to prevent involvement of central nervous system.%目的：探讨原发性乳腺淋巴瘤的临床特点、诊断和治疗方法。方法：回顾性分析1例典型原发乳腺淋巴瘤患者的临床特点、辅助检查和治疗经过，并复习相关文献。结果：原发性乳腺淋巴瘤是原发于乳腺组织的恶性淋巴瘤，临床罕见，以无痛性乳腺包块为常见症状，诊断依赖病理检查，病理类型以弥漫大B细胞淋巴瘤多见。无标准治疗方案，可采用手术、化疗、放疗或联合治疗。结论：原发性乳腺弥漫大B淋巴瘤无特异临床表现和影像学特点，诊断主要依赖空芯针活检或手术切除病变组织行病理组织学检查结合组织化学染色明确，PET／CT影像学检查有助于治疗前后病情全面评估。手术切除治疗对患者无益，化疗和（或）放疗是主要治疗手段，加入利妥昔单抗和鞘内注射化疗药物有助于预防淋巴瘤中枢侵犯。