鼻咽喉头颈区原发淋巴瘤78例分析  

Analysis on clinical features of primary lymphoma in rhinolaryngeal head and neck region

作　　者：赵鹏举 李进让 ZHAO Pengju;LI Jinrang(Department of Otorhinolaryngology Head and Neck Surgery,PLA General Hospital Sixth Medical Center,No.6 Fucheng Road,Haidian District,Beijing 100048,China)

机构地区：[1]中国人民解放军总医院第六医学中心耳鼻咽喉头颈外科,北京100048

出　　处：《中国中西医结合耳鼻咽喉科杂志》2022年第2期131-135,87,共6页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨首发于鼻咽喉头颈部淋巴瘤病例的临床特征,提高该病诊疗水平。方法回顾性收集1990年~2019年的病例,对其性别、年龄、病程、病理类型、发病部位等指标进行分析。结果共有78例,其中男性45例,女性33例,50-70岁为发病高峰。超过83%的患者病程在6个月之内。共有2例霍奇金淋巴瘤,76例非霍奇金淋巴瘤,其中B细胞型51例,T/NKT细胞型25例。发病部位在韦氏环者26例,头颈部和鼻腔各20例。有8例患者活检超过2次才确诊。在非霍奇金淋巴瘤患者中,T细胞型患者外周血淋巴细胞明显低于B细胞型患者,而淋巴细胞/单核细胞比值则是T细胞型患者更低。结论首发于鼻咽喉头颈部的淋巴瘤以结外型非霍奇金淋巴瘤为主,韦氏环为最常见的发病部位。该病缺乏典型临床症状,若误诊可导致不恰当的治疗。鼻腔淋巴瘤患者临床表现有一定特点。对非霍奇金淋巴瘤患者而言,T/NKT细胞型比B细胞型患者的淋巴细胞/单核细胞比值更低,淋巴细胞明显减少,这可能与预后相关。Objective To analyze the clinical features of primary lymphoma in rhinolaryngeal head and neck region.Methods Clinical data of cases diagnosed with lymphoma in our department was collected,from 1990 to 2019.Analyzed parameters include:gender,age,disease course,pathological type,foci site,misdiagnosis,peripheral lymphocyte count,lymphocyte/monocyte ratio(LMR).Results A total of 78 cases were enrolled,including 45 males and 33 females.Over 83%cases had a disease course of less than 6 months.There were 2 Hodgkin’s lymphoma(HL)cases and 76 non-Hodgkin’s lymphoma(NHL)cases.NHL cases were composed of 51 B-cell subtype cases and 25 T/NKT-cell subtype cases.The most involved region was Waldeyer’s Ring.Symptoms were not specific and 14 patients had systemic symptoms,such as fever and weight loss.There were 21.79%patients misdiagnosed.Eight patients had at least 2 biopsies to get diagnosed.In NHL cases,T/NKT-cell subtype had lower lymphocyte count and lower LMR than B-cell subtype.Conclusions Most lymphoma cases arose from rhinolaryngeal head and neck region were extra-nodal NHL cases.Although there was no specific clinical feature in most cases,symptoms and physical examination findings of nasal lymphoma patients might be a reminder of this diagnosis.We can make the right diagnosis in most cases,as long as we stay alert of this disease.For NHL,the lower lymphocyte count and LMR could be associated with a worse prognosis for T/NKT-cell subtype cases,compared with B-cell subtype cases.

关 键 词：鼻 咽喉 头颈 淋巴瘤 

分 类 号：R739.91[医药卫生—肿瘤]