原发性乳腺非霍奇金淋巴瘤  

Primary non-Hodgkin's lymphoma of breast

作　　者：严云[1] 任梅玉[1] 祝明洁[1] 邓晓辉[1] 万江波[1] 梁辉[1] 

机构地区：[1]上海交通大学医学院附属新华医院血液科,200092

出　　处：《上海医学》2006年第6期384-387,共4页Shanghai Medical Journal

摘　　要：目的分析原发性乳腺淋巴瘤(PBL)的临床及病理特点,探讨其诊断方法、治疗体会及预后因素。方法回顾性分析我院1985年8月至2005年8月诊治的11例PBL患者的临床及病理资料。结果11例患者的中位年龄为52岁,均因乳房无痛性肿块就诊。病理诊断均为B细胞性非霍奇金淋巴瘤,黏膜相关淋巴组织型结外边缘区B细胞淋巴瘤(MALT)3例,弥漫大B细胞淋巴瘤(DLBCL)8例。Ⅰ_e期8例,中位随访时间49(29～138)个月；Ⅱ_e期3例,中位随访时间20(6～53)个月。均采用手术切除联合化疗,其中有5例再联合放疗。6例复发,中位复发时间21(16～36)个月,其中3例为中枢神经系统(CNS)复发,无一例生存；同侧或对侧乳房复发3例。3年和5年生存率为63．6%和50．9%。结论PBL的临床及一般影像学表现缺乏特异性,最后诊断需依靠病理组织学及免疫组织化学分析。PBL多为B细胞性,以DLBCL最常见。有较高的CNS复发率,提示在手术联合化疗、放疗的同时应对CNS进行预防性治疗。Objective To analyze the clinical and pathological features of primary breast lymphoma （PBL） and to appraise the diagnotic method, therapeutics and prognostic factors. Methods The clinical and pathological records of 11 PBL patients admitted in Xinhua hospital from Augast 1985 to Augast 2005 were retrospectively analyzed. Results 11 patients with median age of 52 years. Began with painless breast mass and confirmed pathologically as B-cell non Hodgkin＇s lymphoma （NHL）. The median follow-up period of 8 patients with stage ⅠE was 49 months （ 29-138 months） and the median follow-up of 3 patients with stage Ⅱ E was 20 months （ 6-53 months ）. 11 patients were taken mastectomy combined with chemotherapy including 5 with chemoradiotherapy and 6 relapsed of which the median recurrence period was 21 months （ 16-36 months ） involving three of central nervous System （CNS） recurrensce with none alive and the 3 replapsed ipsilaterally and contralaterally. The overall 3-year and 5-year survival rates were 63.6% and 50. 9%. Conclusion The clinical and imaging features of PBL are not characteristic, the diagnosis mainly relies on histopathology and immunohistochemistry. The majority of PBL is of B-cell origin with high incidence of diffuse large B-cell lymphoma prossessin a higher probability of CNS relapse, 27.3% （3/11）, and thus CNS preventive treatment should be given simultaneously.

关 键 词：原发性 乳腺 非霍奇金淋巴瘤 中枢神经系统 复发 

分 类 号：R737.9[医药卫生—肿瘤] R733.4[医药卫生—临床医学]