临床病例讨论:腹胀、右上腹疼痛、肝内占位性病变  

Discussion of clinical cases: abdominal distension,right upper quadrant pain,intrahepatic lesions

作　　者：梁冰[1] 王赫[1] 杨大明[1] 徐克成[1] 

机构地区：[1]广州复大肿瘤医院肿瘤内科,广东广州510300

出　　处：《胃肠病学和肝病学杂志》2009年第9期831-833,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：原发性肝淋巴瘤(primary hepatic lymphoma,PHL)临床十分少见,约占淋巴瘤的0.4%,仅占肝脏恶性肿瘤之0.1%。本病好发于HBV、HCV或人类疱疹病毒(EB)感染者,也易见于AIDS和其他原因如恶性肿瘤、器官移植术后、原发性胆汁性肝硬化(PBC)、干燥综合征、自身免疫性甲状腺炎等引起的免疫功能缺陷患者。PHL因临床症状、实验室检查及影像学检查均无特异性,难以凭临床资料明确诊断,误诊率极高,常误诊为原发性或转移性肝癌、肝血管瘤,甚至肝炎。PHL虽然十分少见,但其治疗方法及预后与其他肝肿瘤不尽相同。本文通过对1例PHL患者的病例讨论,期望加强临床医师对本病的认识。Primary hepatic lymphoma（PHL） is rare in clinic,only accounting for about 0.4% of lymphoma and 0.1% of liver malignancies.PHL usually occurs in patients infected with HBV,HCV or EB,and it is also easy to be found in patients with immunological function deficiency resulting from AIDS or other causes,such as cancer,organ transplantation,primary biliary cirrhosis（PBC）,Sjogren＇s syndrome and autoimmune thyroiditis.It is difficult to identify PHL only through clinical data,because there is no specificity in its clinical symptoms,laboratory examinations and imageology examinations.Besides,there is an extremely high misdiagnosis rate in identifying PHL which is often misdiagnosed as primary or metastatic liver cancer,liver hemangioma and even hepatitis.Although PHL is not seen very often,its treatment and prognosis are quite different from other liver tumors.We aimed to strengthen the clinician＇s awareness of the disease by discussing a PHL patient in this literature.

关 键 词：腹胀 右上腹疼痛 原发性肝淋巴瘤 

分 类 号：R735.7[医药卫生—肿瘤]