肺原发性非霍奇金淋巴瘤临床及病理特点观察

摘要

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联合或不联合利妥昔单抗方案治疗，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。%Objective To explore the clinical and pathological features, treatment and prognosis of primary pulmonary non-Hodgkin' 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.