304例原发性结外淋巴瘤临床病理分析  

Clinical analysis of 304 patients with primary extranodal lymphoma

作　　者：杨喜格 杨锡贵[1] 孟良 常静[4] 姜超[4] 

机构地区：[1]山东省肿瘤医院,济南250117 [2]山东省济宁市汶上县人民医院血液肿瘤科,山东济宁272500 [3]山东省济宁市汶上县人民医院 [4]山东省医学科学院附属医院

出　　处：《临床血液学杂志》2016年第6期894-897,901,共5页Journal of Clinical Hematology

摘　　要：目的：探讨原发性结外型淋巴瘤（PENL）的临床和病理特征。方法：回顾性分析304例PENL的病例资料,从性别、发病年龄、病理类型、起病部位等方面进行总结分析。结果：①304例PENL中位年龄51岁（3-91岁）,41-70岁为高发年龄段;男女比为1.2∶1.0,原发于小肠和腮腺的好发于男性,甲状腺、扁桃体和脾则表现为女性明显多于男性。②本组PENL占同期淋巴瘤的53.0%（304/574）,以非霍奇金淋巴瘤（NHL）为主,占95.1%;霍奇金淋巴瘤（HL）占4.9%。结外NHL占同期NHL的58.1%（289/497）,结外HL占同期HL的19.5%（15/77）。③原发部位广泛,常见于胃肠道（25.0%）、鼻腔（12.2%）、纵膈（9.9%）、扁桃体（9.5%）。④原发于胃肠道、扁桃体、中枢神经系统、骨、乳腺、甲状腺、睾丸、子宫、卵巢、脾、肺、肾等部位的PENL病理类型,以弥漫性大B细胞淋巴瘤常见;原发于鼻腔的PENL病理类型,以结外NK/T细胞淋巴瘤常见。临床分期以Ⅰ期、Ⅱ期为主。结论：PENL发病率较高,发病部位广泛,临床表现多样且无特异性,临床中对各组织器官疾病进行诊断时应警惕淋巴瘤的可能性,尽早行组织病理学检查,避免漏诊和误诊。Objective： To analyze the clinical and pathological characteristics of patients with primary extranodal lymphoma（ PENL）. Method： We analyzed retrospectively clinical data of 304 cases with PENL,including age,sex,pathological classification and onset locus of lymphoma and so on. Result：①The median age of the patients was 51 years（ range 3 to 91 years）,the high incidence of age was 41 to 70 years. The ratio of male to female was 1. 2∶ 1. 0,small intestine and the parotid gland lymphomas were significantly more common in males,while thyroid,tonsils and spleen lymphomas were found more often in females.②The 304 patients with PENL accounted for 53. 0%（ 304 /574） of lymphoma over the same period,among them,95. 1% were non-Hodgkin＇s lymphoma（ NHL） and 4. 9% were Hodgkin＇s lymphoma（ HL）. PENL constituted 58. 1%（ 289 /497） of all NHL during this period and 19. 5%（ 15 /77） of all HL.③The primary sites of involvement were gastrointestinal tract（ 25. 0%）,nasal cavity（ 12. 2%）,mediastinum（ 9. 9%）,tonsils（ 9.5%）.④The common pathological type of gastrointestinal tonsils,central nervous system,bone,breast,thyroid,testis,uterus,ovary,spleen,lung,kidney lymphoma was diffuse large B-cell lymphoma; the common pathological type of nasal cavity lymphoma was extranodal NK / T cell lymphoma. Most PENLs were in stage Ⅰ / Ⅱ. Conclusion： The incidence of PENL is high,disease site is extensive,clinical manifestations have no specific,so in clinical work we should be wary of the possibility of lymphoma. Tissue biopsy should be done as soon as possible,in order to avoid misdiagnosis.

关 键 词：原发性结外淋巴瘤 临床特征 病理特征 

分 类 号：R733.4[医药卫生—肿瘤]