原发前列腺非霍奇金淋巴瘤二例  

Primary non-hodgkin lymphoma of the prostate: two cases report

作　　者：林志欢 李星[1] 董敏[1] 林曲[1] 

机构地区：[1]中山大学附属第三医院肿瘤内科,广州510630

出　　处：《新医学》2015年第5期337-340,共4页Journal of New Medicine

摘　　要：前列腺淋巴瘤在临床上非常罕见,占淋巴瘤的比例不足0.1%,绝大多数为个案报道,预后较差。该文报道了2例前列腺非霍奇金淋巴瘤,例1患者在外院诊断为"前列腺炎",术前诊断为"前列腺平滑肌肉瘤",后行根治性前列腺切除术及原位回肠新膀胱术,术后病理示前列腺B细胞源性非霍奇金淋巴瘤,采用了多种方案化学治疗获得了完全缓解,并维持了近50个月。例2患者在外院MRI提示为前列腺癌,入院后前列腺穿刺活组织检查示非霍奇金淋巴瘤弥漫大B细胞阳性,确诊后行8个疗程R-CHOPE方案化学治疗,获得了持续的部分缓解。2例患者随访至2014年12月24日,均存活,无肿瘤进展,卡帕斯基评分100分。该2例的诊治过程提示,前列腺淋巴瘤属于罕见病,诊断较为困难,容易误诊,治疗以化学治疗为主。Lymphoma of the prostate is extremely rare in clinical settings,accounting for 〈0.1% a-mong all types of lymphoma.A majority of these patients were reported as case report with relatively poor prog-nosis.In this article,two cases diagnosed with non-hodgkin lymphoma of the prostate were reported.Case one was suspected with prostatitis in a local hospital and diagnosed with leiomyosarcoma of the prostate before sur-gery.He underwent radical prostatectomy and orthotopic ileal neobladder.After surgery,he was diagnosed with B-cell non-hodgkin lymphoma of the prostate by pathological examination.Complete remission was achieved af-ter multiple schemes of chemotherapy and was maintained for almost 50 months.Case 2 was suspected with prostate cancer by MRI in another hospital.After admission,he was diagnosed with diffuse large B-cell lym-phoma of the prostate by needle biopsy.Subsequently,he received eight cycles of R-CHOPE.Persistent partial remission was obtained.During the follow-up until 24 December,2014,both patients were alive and had pro-gression-free survival （Karnofsky performance status =100）.The diagnosis and treatment of these two cases prompt that prostate lymphnoma is rarely seen in clinical practice.It is difficult to make a diagnosis and likely to misdiagnose.Chemotherapy remains the primary treatment of lymphoma of the prostate.

关 键 词：前列腺肿瘤 淋巴瘤 诊断 治疗 

分 类 号：R737.25[医药卫生—肿瘤]