艾滋病合并非霍奇金淋巴瘤五例临床分析并文献复习  

A clinical analysis of AIDS-related non-Hodgkin lymphoma in 5 patients and review of literature

作　　者：阮桂仁[1] 王焕玲[1] 葛瑛[1] 侍效春[1] 郭伏平[1] 钟定荣[2] 周道斌[3] 李太生[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院感染内科,100730 [2]中国医学科学院北京协和医学院北京协和医院病理科,100730 [3]中国医学科学院北京协和医学院北京协和医院血液科,100730

出　　处：《中华内科杂志》2012年第3期184-187,共4页Chinese Journal of Internal Medicine

基　　金：卫生部部属（管）医院2010-2012年度临床重点项目

摘　　要：目的通过分析5例艾滋病相关非霍奇金淋巴瘤（ARL）患者的临床资料并复习相关文献，提高对该病的认识。方法回顾性分析北京协和医院2009年4月至2011年4月因非霍奇金淋巴瘤住院的艾滋病患者的临床资料，复习相关文献。结果共收治5例ARL患者，均为男性，年龄32．65岁。2例在淋巴瘤诊治中首次发现HIV感染，3例在抗逆转录病毒治疗（HAART）7-8个月后发现ARL。发病时CD4＋T细胞计数（69-232）×10。／L。2例以咽痛、咽部溃疡起病，1例以颈部包块起病，1例以腹盆腔占位起病，1例以发热、右下肢肿痛起病。4例为B细胞淋巴瘤，其中1例为Burkitt淋巴瘤，3例为弥漫大B细胞性淋巴瘤，1例为T细胞淋巴瘤。4例进行化疗，1例完全缓解，1例复发，1例无缓解，1例死亡；1例进行单纯放疗，出现病变进展。化疗的主要副作用为骨髓抑制及消化道反应。结论HIV感染者若出现不明原因的淋巴结肿大、顽固性咽痛、咽部溃疡、不明原因发热等，应考虑可能为淋巴瘤，尽可能行病理活检明确。积极的HAART联合规范性化疗可能改善预后。Objective To analyze the clinical characteristics of AIDS-related non-Hodgkin lymphoma （ARL） and review relative literature for the diagnosis and treatment of ARL. Method The clinical data of ARL patients admitted to Peking Union Medical College Hospital from April 2009 to April 2011 were retrospectively analyzed. Results Five male ARL patients aged 32 to 65 years old were included in this retrospective study. Among them, two patients were found to be HIV-positive for the first time, three were on regular highly active anti-retroviral therapy （HAART） for 7-8 months before the emergence of lymphoma-related symptoms. CD4＋ T cell count was （69-232） ~ 106/L at presentation. Two patients firstly presented with sore throat and throat ulcer, one with cervical nodules, one with pelvic mass, one with fever and edema in right thigh. Through pathological analysis, four patients had B cell-originated lymphoma, with one Burkitt lymphoma and three diffuse large B cell lymphomas; one patient had T-cell lymphoma. Four patients were treated with chemotherapy, with one complete remission, one relapse, one non-response, and one death. One patient had radiotherapy only and had progressed disease. Bone marrow suppression and gastrointestinal disturbance were the main adverse effects of chemotherapy. Conclusions Lymphoma should be considered in any HIV-infected patients presented with unexplainable adenopathy, recurrent sore throat or throat ulcer, or fever of unknown origin. Biopsy should be rigorously carried out. Appropriate chemotherapy, together with HAART, may improve the prognosis greatly.

关 键 词：获得性免疫缺陷综合征 淋巴瘤 非霍奇金 淋巴瘤 艾滋病相关 回顾性研究 

分 类 号：R733.1[医药卫生—肿瘤]