不一致性淋巴瘤1例及病理分析  

Clinicopathological characteristics of discordant lymphoma:one case report

作　　者：杨翔[1] 张瑗[1] 刘瑜[1] 吴宁[1] 万文辉[1] 王璇[2] 吴楠[2] 翟勇平[3] 

机构地区：[1] 南京大学附属金陵医院 老年病研究中心干部一科,南京210002 [2] 南京大学附属金陵医院 病理科,南京210002 [3] 南京大学附属金陵医院 血液科,南京210002

出　　处：《中华老年多器官疾病杂志》2016年第9期700-703,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：本文回顾了南京大学附属金陵医院干部一科1例不一致性淋巴瘤高龄患者的诊治。患者于1987年以左侧腮腺区淋巴结肿大为首发症状，1988年行左侧腮腺区淋巴结活检诊断为非霍奇金淋巴瘤、小B细胞性淋巴瘤，先后进行了50个疗程的“COP、OP”方案化疗及短期局部放疗。2014年出现咽喉部不适，行会厌部取检，诊断为间变性淋巴瘤酶（ ALK）阴性的间变性大细胞淋巴瘤，最终诊断为不同时发生的不一致性淋巴瘤。不一致性B细胞和T细胞性淋巴瘤非常罕见，取每一个病变部位作活检有助于避免漏诊，从而选择正确的治疗方案。In this article, we reported the successful treatment for an 87-year old male suffering from discordant lymphoma.He initially presented with enlargement of left parotid lymph node in 1987.Then in 1988, he was diagnosed with small B-cell non-Hodgkin’ s lymphoma through lymph node biopsy, and treated with 50 courses of cyclophosphamide, vincristine, prednisone （ COP or OP） , and short-term local radiotherapy.However, he relapsed in 2014 with a sore throat, and an epiglottis biopsy revealed anaplastic lymphoma kinase （ ALK）-negative anaplastic large cell lymphoma.The final diagnosis of the patient was sequential discordant lymphoma consisting of small B-cell non-Hodgkin’ s lymphoma and ALK-negative anaplastic large cell lymphoma.Discordant lymphoma is rare, especially those involving both B cell and T cell.Biopsy for the tissue specimen of every lesion can help avoiding missed diagnosis, and thus choose a more appropriate treatment regimen.

关 键 词：不一致性淋巴瘤 B细胞性淋巴瘤 ALK阴性的间变性大细胞淋巴瘤 老年人 80以上 

分 类 号：R592[医药卫生—老年医学] R733.1[医药卫生—内科学]