脾组织细胞肉瘤一例并文献复习  

Splenic histiocytic sarcoma:report of one case and review of literature

作　　者：许鑫欣 于泳 杨向东[1] 路军华[3] 李翀[4] 闫理想 Xu Xinxin;Yu Yong;Yang Xiangdong;Lu Junhua;Li Chong;Yan Lixiang(Department of Hematology,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China;Department of Hematology,Tumor Hospital of Tianjin Medical University,Tianjin 300060,China;Department of Surgery,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China;Department of Pathology,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China)

机构地区：[1]天津中医药大学第一附属医院血液内科,300381 [2]天津医科大学肿瘤医院血液内科,300060 [3]天津中医药大学第一附属医院外科,300381 [4]天津中医药大学第一附属医院病理科,300381

出　　处：《白血病．淋巴瘤》2021年第6期353-356,共4页Journal of Leukemia & Lymphoma

基　　金：国家自然科学基金(81774048)。

摘　　要：目的提高对脾组织细胞肉瘤诊断及治疗的认识。方法回顾性分析天津中医药大学第一附属医院2020年7月收治的1例脾组织细胞肉瘤患者的临床资料,并复习国内外相关文献。结果该患者经组织病理及免疫组织化学检查确诊为脾组织细胞肉瘤,经甲泼尼龙联合环孢素治疗无效,予全脾切除,后行VECD及CHOP方案化疗,术后5个月随访,病情稳定,复查骨髓穿刺结果显示未见组织细胞肉瘤浸润,获得血液学缓解。结论脾组织细胞肉瘤属于高度恶性肿瘤,起病隐匿,发病机制不明确,临床表现及影像学检查缺乏特异性,诊断依靠病理活组织检查及免疫组织化学检查,需与其他淋巴造血组织恶性肿瘤鉴别。目前尚无最佳治疗方案,多数患者预后不良。Objective To improve awareness of the diagnosis and treatment of splenic histiocytic sarcoma.Methods The clinical data of one patient with splenic histiocytic sarcoma who was admitted to First Teaching Hospital of Tianjin University of Traditional Chinese Medicine in July 2020 were retrospectively analyzed,and the relevant domestic and foreign literature was reviewed.Results The patient was diagnosed as splenic histiocytic sarcoma by histopathological and immunohistochemical examinations.The methylprednisolone combined with cyclosporine was ineffective.The patient received a total splenectomy,followed by chemotherapy with VECD and CHOP regimens.The patient's condition was stable during the 5-month follow-up after the operation.The result of bone puncture showed that there was no infiltration of histocytic sarcoma,and hematological remission was obtained.Conclusions Splenic histocytic sarcoma is a highly malignant tumor with insidious onset,unclear pathogenesis,and lack of specificity in clinical manifestations and imaging examinations.The diagnosis depends on pathological biopsy and immunohistochemistry,and needs to be differentiated from other malignant tumors of lymphoid hematopoietic tissue.At present,there is no best treatment for splenic histiocytic sarcoma,and most patients have a poor prognosis.

关 键 词：脾 组织细胞肉瘤 药物疗法 联合 

分 类 号：R733.2[医药卫生—肿瘤]