首页> 中文期刊> 《临床与实验病理学杂志》 >肺原发性非霍奇金淋巴瘤28例临床病理分析

肺原发性非霍奇金淋巴瘤28例临床病理分析

         

摘要

Purpose To explore the clinicopathological characteristics of primary non-Hodgkin lymphoma ( PNHL) of lung. Methods The clinical features, morphology and immunohistopathological phenotypes were retrospectively studied in 28 cases of PNHL and re-viewed of the literature. Results The composition of this group of cases is 18 cases of male, 10 cases female. The a median age of pa-tients was 57 years old. According to the WHO classification, all of the 28 cases of in our PNHL series were diagnosed as non-Hodgkin lymphoma ( NHL) , including 17 mucosa-associated lymphoid tissue extranodal marginal zone lymphomas ( MALT) , 5 diffuse large B cell lymphomas ( DLBLC) , 2 NK/T cell lymphomas and 2 anaplastic large cell lymphomas, 1 mantle cell lymphoma ( MCL) and 1 pe-ripheral T cell lymphomas, unspecified, respectively. One-third PNHL patients presented with specific clinical symptoms such as cough, chest pain, dyspnea, and fatigue, Imaging examination showed unilateral or bilateral pulmonary infiltrate, single lesions or multiple nodules, and the lesions always involved with the trachea, bronchus and lung. Follow-up was completed in 16 patients ( range, 3 to 38 months) . 3 cases were conducted with pneumonectomy, among which 2 cases were given postoperative adjuvant chem-otherapy. Seven patients were given chemotherapy alone, and 5 patients did not give any treatment following initial diagnosis. At the time of last follow-up, 13 patients were alive with disease, 2 patients were died. The tumor metastasis in the left inguinal lymph node was found in one patient after 2 years by surgery. Conclusions It was shown that there was no specific clinical manifestations and fea-tures of pulmonary PNHL. Among of them, the MALT is the most common diseases, and the highly aggressive lymphomas many be oc-cur, such as the DLBLC, NK/T cell lymphoma. The diagnosis of PNHL depends on pathological examination. The immunohistochemi-cal staining and molecular pathological technology may helpful for the diagnosis and differential diagnosis of the tumors.%目的:探讨肺原发性非霍奇金淋巴瘤( primary non-Hodgkin lymphoma, PNHL)的临床病理学特征。方法回顾性分析28例肺PNHL临床表现、影像学和病理学特征,并复习相关文献。结果28例肺PNHL中,男性18例,女性10例,年龄27~82岁,中位年龄57岁。28例均为非霍奇金淋巴瘤( non-Hodgkin lymphoma, NHL),其中黏膜相关淋巴组织结外边缘区淋巴瘤17例,弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma, DLBLC)5例,NK/T细胞淋巴瘤2例,间变性大细胞淋巴瘤(ana-plastic large cell lymphoma, ALCL)2例,套细胞淋巴瘤(mantle cell lymphoma, MCL)及外周T细胞淋巴瘤,非特指各1例。1/3肺PNHL患者无特异性临床症状,主要表现为咳嗽、胸痛、呼吸困难和乏力等。影像学检查多数表现为单肺或双肺阴影,孤立或多发结节,并可累及气管或支气管。随访16例,时间3~38个月,3例患者行肺叶切除术(2例术后辅助化疗),7例行单纯化疗,5例未行任何治疗。13例生存,2例死亡,1例术后2年出现左侧腹股沟淋巴结转移。结论肺PNHL的临床和影像学无特异性改变,以黏膜相关淋巴组织结外边缘区淋巴瘤最常见,其他少见的高度侵袭性淋巴瘤也可发生。确诊需依赖病理检查,免疫组化及分子病理学检测有助于该类型淋巴瘤的诊断。

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