原发于骨和肾及回肠的结外淋巴瘤病例讨论  

Primary multifocal extranodal lymphoma in left humerus, two kidneys and ileum： one case report and literature review

作　　者：周学慧[1] 郑平[2] 翟树森[1] 张瑞萍[1] 张怡堃[1] 

机构地区：[1]解放军第306医院血液肿瘤科,北京100101 [2]解放军第306医院航天城临床部,北京100101

出　　处：《中华老年医学杂志》2017年第9期1030-1034,共5页Chinese Journal of Geriatrics

摘　　要：诊治要点： 原发性结外淋巴瘤（PENL）是原发于结外淋巴组织或非淋巴组织的恶性肿瘤。近年来PENL发病呈上升趋势，但发生于3个及3个以上器官的PENL罕见，迄今为止仅有3例报道。In this paper,we analyzed one case of primary multifocal extranodal non-Hodgkin＇s lymphoma and reviewed the related literatures. We investigated the clinical data of this case with primary multifocal extranodal lymphoma and retrospected the related references. The key words, primary extranodal lymphoma and multifocal,were used to search Pubmed and Wanfang Database,and finally only three cases were found. The 68-year-old woman was eonfirmatively diagnosed as primary multifocal extranodal B cell non Hodgkin＇s lymphoma. The positron emission tomography/computed tomography （PET/CT） scan showed multiple hypermetabolic lesions in the left humerus, both kidneys and ileum. The confirmative diagnosis was based on clinical manifestations and serological tests, imaging features of CT and PET/CT,and especially on the histopathological and immunohistochemical studies. After one cycle chemotherapy （rituximab, Vincristine and prednisone） and another cycle （rituximab, Vincristine, cyclophosphamide and prednisone）, a repeat PET/CT scan showed a complete metabolic resolution of the lesions in the kidneys and ileum, and a partial metabolic resolution of the left humerus. After four cycles of chemotherapy, there were new extensive involvements of the right supraclavicular and intrapulmonary lymph nodes, bilateral pleural and pericardium, and the patient gave up chemotherapy. This case demonstrated the imaging findings of an uncommon primary multifocal extranodal lymphoma in left humerus, both kidneys and ileum, and highlighted the usefulness of CT and PET/CT scan in identifying the extent of disease involvement,in guiding a biopsy,and in assessing the treatment response of lymphoma. It is essential to differentiate between primary muhifocal extranodal lymphoma and lymphoma extensive metastases.

关 键 词：淋巴瘤 骨 肾 回肠 

分 类 号：R733.1[医药卫生—肿瘤]