原发性肾上腺非霍奇金淋巴瘤(附9例报告)  

Primary Adrenal Non-Hodgkin's Lymphoma:Report of 9 Cases

作　　者：汪菲[1,2,3] 崔亮[1,2,3] 王晓雄[1,2,3] 高江平[1,2,3] 高春记[1,2,3] 曾强[1,2,3] 

机构地区：[1]中国人民解放军总医院国际医学中心,北京100853 [2]中国人民解放军总医院泌尿外科,北京100853 [3]民航总医院泌尿外科,北京100123

出　　处：《现代生物医学进展》2012年第11期2074-2076,2073,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨原发性肾上腺淋巴瘤(Primary Adrenal Lymphoma,PAL)的临床特点、提高对PAL的认识。方法:回顾分析解放军总医院1995年12月至2007年6月收治的9例PAL的临床表现、实验室检查、影像学特点、组织病理类型以及治疗方法等临床资料,并结合国内外文献进行分析。结果:9例患者中,1例因常规体检发现,8例因腹痛、腹胀或腰痛就诊发现;其中单侧3例,双侧6例,实验室检查无明显异常,影像学检查仅发现肾脏肿瘤,但术后病理组织学诊断为非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL),其中8例弥漫大B细胞淋巴瘤,1例T细胞淋巴瘤;7例患者术后均接受了CHOP或RCHOP方案化疗为主的综合治疗,2例常规治疗;随访至2010年2月,1例弥漫性大B细胞淋巴瘤患者存活4年,1例在术后3年2个月死亡,余7均在2年内死亡。结论:PAL是一种罕见的、恶性程度较高的肿瘤,临床表现和影像学检查缺乏特异性,组织病理学及免疫组织化学是明确诊断的好方法。术前确诊肾上腺原发性非霍奇金淋巴瘤可避免手术,联合化疗应为治疗首选。Objective： To investigate the clinical characteristics of primary adrenal non-Hodgkin＇s lymphoma（PAL）,so as to improve comprehension of that unusual lesions.Methods： Nine cases of patients with a confirmed diagnosis of PAL were retrospectively reviewed.The clinical presentation,laboratory examination,imaging characteristics,histopathology types and treatment were analyzed.Results： 1 case was occasionally detected by health examination and 8 patients complained of stomachache,abdominal distension or lumbago.3 patients were unilateral lymphoma,and other patients were bilateral.There was non-apparent abnormality in the check of laboratory.The adrenal tumors were found by imaging examination,but the diagnosis of non-Hodgkin＇s lymphoma（NHL） was confirmed by histopathological examination.8 cases were diffuse B-cell origin lymphoma and 1 case was T-cell origin lymphoma.They all received CHOP or RCHOP chemotherapy.Follow up over in February,2010,1 patient has been alive for 4 years and 1 patient died postoperative 3 years and 2 months,other 7 cases died within 2 years.Conclusions： PAL is a rare malignancy.The presenting symptoms and imaging modalities of PAL were nonspecific and misdiagnosis rate was high.The definitive diagnosis of PAL depended on histopathology and immunohisto-chemistry of adrenal tissue.Surgical operative could be avoided if the diagnosis was made preoperative.The primary management in the treatment of PAL was combination chemotherapy.

关 键 词：肾上腺 淋巴瘤 非霍奇金 诊断 预后 

分 类 号：S858.317.4[农业科学—临床兽医学]