腹膜后肿块为首发症状的恶性淋巴瘤临床特点分析  

Clinical Characteristics of Malignant Lymphoma with Retroperitoneal Mass as the Primary Presentation

作　　者：金哈斯[1] 宫丽平[2] 倪美兰[1] 孟文霞[1] 林美雄[1] 母立新 

机构地区：[1]武警总医院门诊部,北京市100039 [2]首都医科大学病理系 [3]首都机场医院外科

出　　处：《中国肿瘤临床》2012年第6期343-347,共5页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨腹膜后肿块为首发症状的恶性淋巴瘤的临床特点、治疗及预后。方法:回顾性收集自2002年1月至2010年12月间收治的20例腹膜后肿块为首发症状的恶性淋巴瘤患者的临床资料,分析其病理活检方式、病理类型、免疫组化、分期、治疗效果、生存率等。研究手术、年龄、性别、分期、巨大包块、B症状、病理类型对近期疗效的影响结果:20例患者中11例(55%)为弥漫大B细胞性淋巴瘤,4例(20%)为滤泡性淋巴瘤,2例(10%)为小淋巴细胞性淋巴瘤/慢性淋巴细胞白血病,1例(5%)为淋巴母细胞性淋巴瘤,1例(5%)为间变细胞淋巴瘤,1例(5%)霍奇金淋巴瘤。全组患者化疗后完全缓解7例(35%),部分缓解8例(40%);5例就诊后3个月之内早期死亡,9例起病后4～36个月之间疾病进展或复发死亡。全组患者中5年生存率仅20%。手术、病理类型、年龄、大包块、浸润周围器官广泛、静脉血栓形成、肝功能异常、B症状对近期疗效有明显影响结论:腹膜后肿块为首发症状的恶性淋巴瘤缓解率和长期生存率较低,预后差。病理类型、手术、大包块、浸润周围器官、肝功能异常、静脉血栓形成、B症状对缓解率和长期生存率有明显影响。Objective： To investigate the clinical characteristics,treatment outcomes and prognostic factors of patients with malignant lymphoma with primary retroperitoneal mas as the primary presentation. Methods： A total 20 cases of malignant lymphoma with primary retroperitoneal presentation lymphoma seen in our hospital from January 2002 to Decemter 2010 Biopsy method, tissue pathology, im- munochemistry, treatmemt outcome and long time survival were analyzed retrospectively. The influences of age, sex, pathologic type, clinical stage, huge mass and B symptom were analyzed. Results： Among the 20 cases, 11 （ 55 % ） were diffuse large B cell lymphoma, 4 （ 20 % ） were follicular lymphoma, 2 （ 10 % ） were B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma, 1 （ 5% ） was lymphoblastic lymphoma, 1 （ 5 % ） was anaplastic large cell lymphoma and 1 （ 5 % ） was Hodgkin lymphoma. Among the 20 cases, 7 （ 35 % ） had complete remission, 8 （ 40 % ） had partial remission, 5 （ 25 % ） died. The 3-year accumulated survival of the whole group was 30 %,The 5-year accumulated survival of the whole group was only 20%. Conclusion： Complete remission rate and long term survival rates of malignant lymphoma with primary retroperitoneal presentation were low. Pathological type, surgery, huge mass, B symptom, hepatic deysfunction, and infiltrating surrounding organs significantly affect long term survival.

关 键 词：恶性淋巴瘤 原发腹膜后肿块 非霍奇金淋巴瘤 放疗 化疗 病理类型 

分 类 号：R735.4[医药卫生—肿瘤]