5例原发性甲状腺淋巴瘤的临床报道并文献复习  

Clinical Report and Literature Review of 5 Cases of Primary Thyroid Lymphoma

作　　者：张定喜 孔伟博 马超 ZHANG Dingxi;KONG Weibo;MA Chao(Department of General Surgery,Xuchang People’s Hospital,Xuchang 461000,China)

机构地区：[1]许昌市人民医院普通外科,河南许昌461000

出　　处：《河南医学研究》2021年第28期5231-5233,共3页Henan Medical Research

摘　　要：目的分析5例原发性甲状腺淋巴瘤(PTL)患者的临床表现及诊治经过,并对PTL的诊疗进展进行文献复习。方法分析许昌市人民医院2014年1月至2020年12月收治的5例PTL患者的临床表现及诊治经过。结果5例患者中男2例,女3例,中位年龄61岁,中位病程4个月,均因短期内迅速增大的颈部肿块就诊,所有患者均行手术治疗,术后4例患者进一步化疗,化疗患者中有2例进一步放疗,术后病理诊断为弥漫大B细胞淋巴瘤(DLBCL)3例,黏膜相关淋巴组织(MALT)淋巴瘤2例,4例伴有桥本甲状腺炎(HT)。术后随访至2020年12月31日,均无瘤生存。结论老年HT患者出现迅速增大的颈部肿块,伴颈部淋巴结肿大或气管受压时,需高度警惕PTL的可能性,确诊依赖于病理组织学和免疫组织化学检查。目前推荐局部放化疗为主的综合治疗,外科手术仅以切除、活检和缓解压迫为目的,预后在很大程度上取决于组织学分类和疾病分期。Objective To analyze the clinical manifestations,diagnosis and treatment of 5 cases of primary thyroid lymphoma(PTL)and review the literatures on the progress of diagnosis and treatment of PTL.Methods The clinical manifestations,diagnosis and treatment of 5 patients with PTL admitted to Xuchang People’s Hospital from January 2014 to December 2020 were analyzed.Results Among the 5 patients,there were 2 males and 3 females.The median age was 61 years old.The median course of disease was 4 months.All the patients presented to the doctor because of a rapidly enlarged neck mass in a short period of time.All the patients underwent surgical treatment.Four patients received further chemotherapy after surgery,and two of the chemotherapy patients received further radiotherapy.The postoperative pathological diagnosis was diffuse large B cell lymphoma(DLBCL)in 3 cases,mucosa-associated lymphoid tissue(MALT)lymphoma in 2 cases and Hashimoto thyroiditis(HT)in 4 cases.Postoperative follow-up lasted until December 31,2020,and all the patients survived without tumor.Conclusion The diagnosis of PTL should be considered when dealing with rapidly enlarged neck mass with enlarged neck lymph nodes or tracheal compression in elder patients with Hashimoto thyroiditis,and the diagnosis depends on histopathological and immunohistochemistry.At present,local chemoradiotherapy is recommended as the main comprehensive treatment.The purpose of surgery is only to remove and biopsy,to reduce compression.The prognosis depends on histological classification and stages of disease to a great extent.

关 键 词：原发性甲状腺淋巴瘤 桥本甲状腺炎 诊断 治疗 

分 类 号：R736.1[医药卫生—肿瘤]