原发性骨淋巴瘤九例诊治分析  

Primary lymphoma of bone： 9 cases reports and a clinical analysis of diagnosis and treatment

作　　者：裴瑞君 魏娜[1] 王旖旎[1] 汤然[1] 李硕[1] 王昭[1] 

机构地区：[1]首都医科大学附属北京友谊医院血液科,100050

出　　处：《白血病．淋巴瘤》2015年第2期101-104,110,共5页Journal of Leukemia & Lymphoma

基　　金：国家自然科学基金（81270653）;国家自然科学基金青年科学基金（81401627）;北京自然科学基金（7132087）;北京市科技计划首都市民健康项目培育（Z131100006813041）;北京市优秀人才资助项目

摘　　要：目的分析原发性骨淋巴瘤（PBL）患者的临床特点、治疗策略及预后。方法回顾性分析9例PBL患者的临床资料，所有患者原发病变均位于骨骼，无其他组织起病证据。患者均经病理及免疫组织化学确诊为PBL，临床及影像学检查均无特殊表现。结果9例患者中，男6例，女3例，中位年龄34岁（15—71岁）。全部患者均以局部疼痛或肿胀为首发症状，单发骨病灶7例，多发骨病灶2例。原发病灶部位：骨盆4例（髂骨3例、骶骨1例），股骨1例，肱骨1例，肩胛骨1例，椎体2例。其中2例接受放化疗联合治疗，3例进行化疗联合造血干细胞移植治疗，1例行化疗联合手术治疗，3例行单纯化疗。中位随访8个月，总体有效6例（完全缓解5例，部分缓解1例）。结论PBL临床少见，诊断标准和治疗方式仍在探索中，早期诊断和治疗预后较好。对于单发骨痛、软组织肿胀或不明原因骨折的患者，应高度警惕PBL的可能，尽早进行病理检查。Objective To analyze the clinical characteristics, treatment and prognosis of primary lymphoma of bone （PLB）. Methods Retrospective analysis of 9 cases with newly diagnosed PLB was performed. The primary lesion was located in bone and no evidence of lesion was found in other tissues. All the lesions were confirmed by histological examination and immunohistochemical staining. The clinical manifestation and radiological appearance of all cases were non-specific. Results 9 patients were enrolled in the current study including 6 males and 3 females with average age of 34 years old （15-71 years old）. All cases had suffered local pain or edema as initial symptom. Single bone infiltration was detected in 7 patients, while multiple bones infiltration was noticed in 2 patients. The lesion distribution was as follows： 4 lesions were situated in pelvis （3 in ilium and 1 in sacral）, 1 in femur, 1 in humerus, 1 in scapula, and 2 in spine. 2 cases were treated with radiotherapy and chemotherapy, 3 cases were treated with chemotherapy and hematopoietic stem cell transplantation, 1 case was treated with chemotherapy and surgery, and 3 cases received chemotherapy alone. With in a median follow-up of 8 months, 6 patients showed overall response （including 5 cases of complete response and ! case of partial response）. Conclusions PLB is a rare condition, and the diagnostic criteria and treatment are still not well defined. Early diagnosis and prompt treatment usually achieves satisfactory prognosis. The possibility of PLB must be concerned for patients with bone pain, soft tissue swelling or unexplained fractures, and pathological examination should he carried on as soon as possible.

关 键 词：骨 淋巴瘤 临床特点 治疗 

分 类 号：R738.1[医药卫生—肿瘤]