原发性肺非霍奇金淋巴瘤的临床特点及预后分析

摘要

Objective To study the clinical characteristics and outcome of patients with primary pulmonary nonHodgkin's lymphoma (PPL). Methods The clinical features, diagnostic methods, pathological types and outcome of 30 patients with PPL diagnosed in PUMC Hospital were analyzed retrospectively. Results Of these 30 patients, 46. 7％ of patients were male and the median age was 46 years. These patients didn't have specific clinical symptoms and radiological features and 20％ patients were asymptomatic. The median time from onset to diagnosis of all patients was 8 months. The positive diagnostic rate of transbronchial lung biopsy, lung biopsy guided by computer tomography, and lung biopsy by thoracoscopy was 33. 3％, 50％ and 100％, respectively. The mucosa-associated lymphoid tissue (MALT) lymphoma was the main type in PLL, which was found in 56. 7％ patients. Seven of 30 patients died after 39 months of median follow-up time. Compared with patients with non-MALT lymphoma, patients with MALT lymphoma had lower international prognostic index (IPI) score and better prognosis. Conclusion The PPL is an uncommon extra-nodular lymphoma and is difficult to diagnose. The patients with non-MALT lymphoma have better prognosis in PPL.%目的 研究原发性肺非霍奇金淋巴瘤(PPL)的临床特征及预后.方法 回顾性分析北京协和医院确诊的30例PPL的临床表现、诊断手段、病理类型以及预后.结果 病例中,男性占46.7%,中位年龄为46岁.PPL患者没有特异的临床症状及影像学表现,甚至20%患者可无任何症状.中位发病至诊断时间为8个月,经支气管肺活检及经CT引导下肺活检的诊断率分别为33.3%和50%,而胸腔镜下肺活检及开胸肺活检的诊断率为100%.黏膜相关淋巴组织(MALT)淋巴瘤最为常见,占56.7%.在中位随诊39个月后,30例患者中有7例患者(23.3%)死亡.MALT组患者较非MALT组患者有着更低的IPI评分及更好的预后.结论 PPL是一种罕见的结外淋巴瘤,其诊断较为困难,非MALT类型的淋巴瘤患者预后较差.