14例原发性鼻窦非霍奇金淋巴瘤的临床分析  

Primary Non-Hodgkin's Lymphoma of the Paranasal Sinuses: A Report of 14 Cases

作　　者：苏争艳[1] 张东生[1] 朱美琴[1] 史艳侠[1] 姜文奇[1] 

机构地区：[1]华南肿瘤学国家重点实验室

出　　处：《癌症》2007年第8期919-922,共4页Chinese Journal of Cancer

摘　　要：背景与目的:原发性鼻窦非霍奇金淋巴瘤(primary paranasal sinus lymphoma,PPSL)临床上较罕见,其生物学行为较独特。本文总结和分析PPSL的临床病理特点和治疗情况,以期增加对此病的认识。方法:回顾性分析1994～2006年中山大学肿瘤防治中心收治的14例PPSL,分析其临床和病理特点、治疗经过和随访结果。结果:14例中原发于上颌窦者11例,筛窦2例,蝶窦1例。根据淋巴瘤AnnArbor分期,所有患者均为Ⅰ～Ⅱ期。根据美国癌症联合委员会(AJCC)的鼻窦实体瘤TNM分期标准,大部分患者(11/14)属于局部晚期T3～T4。病理类型:B细胞性12例(85.7%),其中弥漫大B细胞性占42.9%(6例);T细胞性1例,非B非T细胞性1例。2例接受上颌窦根治术,12例为肿物切除或活检;14例全部接受化疗,6例化疗后接受局部放疗。中位生存期59.5个月,全组5年总生存率和无事件生存率均为78.6%。结论:PPSL发病部位以上颌窦多见,病理类型以B细胞性为主,其中弥漫大B细胞性最常见,肿瘤局部侵犯广泛为其重要特征;采用全身化疗和局部放疗联合治疗,患者总体预后相对较好。BACKGROUND ＆ OBJECTIVE： Primary paranasal sinus lymphoma （PPSL） is a rare presentation of extranodal non-Hodgkin＇s lymphoma with a natural history distinct from other lymphomas. This study was to evaluate the clinical and pathologic characteristics, treatment outcomes and prognosis of PPSL. METHODS： The records of 14 PPSL patients, treated at Cancer Center of Sun Yat-sen University from 1994 to 2006, were analyzed. RESULTS： The primary involvement sites included the maxillary sinus （11 cases）, ethmoid sinus （2 cases）, and sphenoid sinus （1 case）. All patients were at stage Ⅰ - Ⅱ （Ann Arbor system）. According to the AJCC TNM staging system, most patients had advanced T3-T4 disease. Of the 14 patients, 12 had B-cell PPSL, 1 had T-cell PPSL, and 1 had unclassified PPSL. The most common type was diffuse large B-cell PPSL （6 cases, 42.9%）. Two patients underwent total maxillectomy and 12 underwent local excision or biopsy. All patients received chemotherapy and 6 received radiotherapy after chemotherapy. Both 5-year overall and event-free survival rates were 78.6%, with a median survival of 59.5 months （range, 2-192 months）. CONCLUSIONS： PPSL is an uncommon presentation of lymphoma characterized by bulky local disease. Diffuse large B-cell lymphoma is the most common histologic type and the maxillary sinus is the most common original site of PPSL. A combined-modality approach with systemic chemotherapy and local-regional radiation is recommended for PPSL patients. The prognosis of PPSL is relatively good.

关 键 词：非霍奇金淋巴瘤 鼻窦 临床病理学 治疗 疗效 

分 类 号：R739.6[医药卫生—肿瘤]