同时性双原发非霍奇金淋巴瘤合并上皮性癌五例临床病理分析  

Synchronous primary non-Hodgkin's lymphoma and carcinoma:A clinico-pathologic analysis of 5 patients

作　　者：张静敏[1] 马捷[1] 石群立[1] 周航波[1] 陆珍凤[1] 

机构地区：[1]南京军区南京总医院病理科,江苏南京210002

出　　处：《中华肿瘤防治杂志》2011年第14期1127-1130,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：为了探讨同时性双原发非霍奇金淋巴瘤合并上皮性癌的临床病理学特征,对5例同时性双原发非霍奇金淋巴瘤合并上皮性癌进行形态学和免疫组织化学观察,结合临床资料进行分析并复习相关文献。5例同时性双原发非霍奇金淋巴瘤合并上皮性癌患者中男2例,女3例,年龄52~64岁。5例患者均属于同发性肿瘤,其中2例是术前检查时发现,1例是术中发现,2例是术后复查中发现。本研究中5例淋巴瘤患者均为B淋巴细胞性,其中3例为结外弥漫性大B细胞淋巴瘤（DLBCL）,1例为淋巴结DLBCL,1例为淋巴结惰性小B细胞淋巴瘤;5例上皮性癌中4例为腺癌,另1例为甲状腺髓样癌。4例DLBCL合并癌患者均先行积极的手术治疗,并辅以针对性的术后化疗方案（或放疗）,随访5~50个月均生存。初步研究结果提示,淋巴瘤与癌同时性双原发的病例非常少见,术前、术中和术后全面仔细的检查有助于发现多原发恶性肿瘤。该类患者临床应积极行根治性手术,并辅以术后规范化化疗以延长患者生命。The objective of this study was to study the clinical and pathologic features of synchronous primary non-Hodgkin＇s lymphoma and carcinoma.Five cases of synchronous primary non-Hodgkin＇s lymphoma and carcinoma were observed by HE and immunohistochemical staining,and analyzed with their clinical features.Five patients with 2 male and 3 female,ranging from 52 to 64 years old,were diagnosed by examination before the surgery 2,in the course of the surgery 1,and after the surgery 2.The diagnosis of 5 patients was all B-cell lymphoma with 3 extra-nodal diffuse large B cell lymphoma（DLBCL）,1 nodal DLBCL and 1 nodal small B-cell lymphoma.The synchronous carcinomas of 5 patients included 4 adenocarcinoma and 1 thyroid medullary carcinoma.Four patients with DLBCL received surgery and chemotherapy（or radiotherapy） and were dire in 5-50 months follow-up.In conclusions,synchronous primary non-Hodgkin＇s lymphoma and carcinoma are rare,which may be unexpected discovered by careful examination.Complete surgery and regular chemotherapy can help to prolong the live of patients of synchronous multiple malignant tumors.

关 键 词：多原发癌 诊断 治疗 预后 

分 类 号：R733.1[医药卫生—肿瘤]