原发性骨淋巴瘤患者临床及病理特点分析  

Clinical and pathological characteristics of primary bone lymphoma

作　　者：房立娟[1] 陆敏秋[1] 褚彬[1] 石磊[1] 吴梦青[1] 付丽娜[1] 高珊[1] 项秋晴 鲍立[1] 

机构地区：[1]北京积水潭医院血液内科,100035

出　　处：《中国医药》2016年第7期1051-1055,共5页China Medicine

基　　金：北京市自然科学基金（7162080）

摘　　要：目的探讨原发性骨淋巴瘤（PBL）患者的临床及病理特点。方法回顾性分析1995年8月至2015年8月北京积水潭医院诊断的48例PBL患者的临床及病理特点、治疗和随访情况。结果48例PBL患者年龄5～77岁，中位年龄48．5岁，首发症状均为骨痛；单发性骨病变46例，多发性骨病变2例。病变部位：四肢骨26例（54．2％），其中肱骨5例（10．4％）、股骨12例（25．O％）；中轴骨22例（45．8％），其中脊柱9例（18．8％），骨盆9例（18．8％）。病理类型为非霍奇金淋巴瘤40例（83．3％），其中弥漫性大B细胞淋巴瘤（DLBCL）33例（68．8％）；霍奇金淋巴瘤8例（16．7％）。1例非霍奇金淋巴瘤患者行异基因造血干细胞移植，1例DLBCL患者接受CHOPE方案（环磷酰胺＋阿霉素＋长春新碱＋泼尼松＋足叶乙苷）联合放疗治疗，32例DLBCL患者接受CHOP±R（利妥昔单抗）方案治疗，所有霍奇金淋巴瘤患者均接受ABVD方案（阿霉素＋博莱霉素＋长春新碱＋氮烯咪胺）化疗。确诊后1年内死亡患者1例，实际1年总生存率为97．9％（47／48）；2年内复发患者3例，实际2年无疾病进展生存率为91．7％（44／48）。结论PBL是一类临床罕见的结外淋巴瘤，单骨侵犯多见，病变部位多见股骨，以DLBCL为主要病理类型，预后良好。Objective To investigate clinical and pathological characteristics in patients with primary bone lymphoma （PBL）. Methods Totally 48 patients with PBL from August 1995 to August 2015 were retrospectively enrolled. Clinical and pathological characteristics, data of treatment and follow-up were analyzed. Results The average age of 48 patients was 48.5 years （5-77 years ）; ostealgia were initial symptoms in all patients（ 100. 0% ） ; there were 46 cases of solitary bone lesion and 2 cases of multiple bone lesions. Limb bone accounted for 26 cases（54. 2% ）, including 5 cases（ 10. 4% ） of humeral lesion and 12 cases（25.0% ） of femoral lesion; axial skeleton accounted for 22 cases（45.8% ）, including 9 cases（ 18.8% ）of spinal and pelvinus lesions. Non-Hodgkin＇s lymphoma accounted for 40 cases （ 83.3% ）, including 33 cases （68.8%） of diffuse large B-cell lymphoma（DLBCL） ; Hodgkin＇s lymphoma accounted for 8 cases（ 16. 7% ）. One case of non-Hodgkin＇s lympho- ma underwent allogeneic hematopoietic stem cell transplantation. One case of DLBCL received CHOPE（cyclophos- phamide ＋ adriamycin ＋ vincristine ＋ prednisone ＋ etoposide） chemotherapy combined with radiotherapy and other 32 cases of DLBCL received CHOP-＋ R（rituximab） chemotherapy. All patients with Hodgkin＇s lymphoma received ABVD（ adriamycin ＋ bleomycin ＋ vincristine ＋ dacarbazine） chemotherapy. In present study, 1 case died within 1 year after diagnosis and the actual 1-year survival rate was 97.9% （47/48） ; 3 cases relapsed within 2 years and the actual 2-year disease free survival rate was 91.7% （44/48）. Conclusions PBL is a kind of clinical rare extranodal lymphoma; the most common type is solitary bone lesion and the most common site is femur; DLBCL is the major pathological type.

关 键 词：原发性骨淋巴瘤 临床特点 病理特点 

分 类 号：R733.4[医药卫生—肿瘤]