原发性乳腺淋巴瘤15例临床分析  

Clinical analysis of 15 cases of primary breast malignant lymphoma( PBL)

作　　者：李晓勇[1] 刘宇宏[2] 樊华[1] 李建[1] 

机构地区：[1]延安大学附属医院普外科三病区,陕西延安716000 [2]延安大学附属医院血液免疫科,陕西延安716000

出　　处：《现代肿瘤医学》2014年第10期2329-2331,共3页Journal of Modern Oncology

基　　金：陕西省卫生厅科研项目基金(编号:2012D19)

摘　　要：目的:探讨原发性乳腺淋巴瘤(PBL)临床病理特点、诊断、预后及治疗方法。方法:收集并分析延安大学附属医院2003年12月-2013年12月15例PBL患者的临床资料和治疗随访情况。结果:15例患者全部为女性,发病年龄25-68岁,中位年龄47.8岁。据2001年WHO淋巴瘤病理分类标准,14例为B细胞来源,1例为T细胞来源。具体分类为12例弥漫大B细胞淋巴瘤(DLBCL),1例黏膜相关淋巴瘤(MALT),1例滤泡性淋巴瘤(FL),1例T淋巴母细胞淋巴瘤(T-LBL)。10例行乳腺局部肿块切除,3例行乳腺改良根治术,1例行单侧乳腺切除。14例患者术后接受了全身化疗,1例患者因经济原因放弃化疗。所有患者随访时间为6-112月,中位随访时间24个月。3、5年生存率60%、46.7%。结论:PBL的预后与分期、淋巴瘤预后指数(IPI)、病理组织学、治疗方式有关。PBL多为弥漫大B细胞型,预后差。PBL采用局部切除术联合放、化疗的综合治疗。对于中高度恶性的PBL,首次治疗时接受CNS预防是必要的。Objective：To analyze the clinical pathological feature,diagnosis,treatment and prognosis of primary breast lymphoma（ PBL）. Methods：The clinical profiles of 15 patients with primary breast lymphoma were selected, clinical records and therapy state were reviewed. Results：All of the 15 cases were female,the onset age was from 25 to 68,and the median age 47. 8. All patients were non-Hodgkinˊs lymphoma. According to the lymphoma pathological classification system by WHO,14 cases were B-centroblastic-centrocytic lymphoma（ 12 diffuse large B-centro-blastic-centrocytic lymphoma,1 mucosa-associated,1 follicular lymphoma）,1 lymphoblastic lymphoma. 10 cases received local excision of mammary gland,3 cases received radical mastectary,1 case received unilateral breast remov-al. 14 patients received tumor resection and chemotherapies after operations. Only 1 patient gave up. The period of fol-low up was 6-112 months,and the median was 24 months,the 3 and 5 years survival rates were 60%,46. 7%,re-spectively. Conclusion：Primary malignant lymphomas of breast are mostly diffuse large B cell type,and have a worse prognosis. Prognosis of PBL patients was associated with the pathological classification,stage,IPI,and treatment. The present treatment method for PBL is comprehensive way of partial resection with radiotherapy and chemotherapy. For the intermediate or highly malignant PBL patients,it is necessary to receive CNS protection when receiving the primary treatment.

关 键 词：乳腺淋巴瘤 病理 治疗 预后 

分 类 号：R737.9[医药卫生—肿瘤]