以肺部感染、肝脓肿为首发表现的原发性脾淋巴瘤1例并文献复习  

A case of primary splenic lymphoma with pulmonary infection and liver abscess as the initial manifestations and review of relevant literature

作　　者：马祥[1] 胡凤英 李群英[1] 王永生[1] MA Xiang;HU Fengying;LI Qunying;WANG Yongsheng(Department of Respiratory and Critical Care Medicine,Chengdu First People’s Hospital,Sichuan,Chengdu 610041,China)

机构地区：[1]成都市第一人民医院呼吸与危重症医学科,四川成都610041

出　　处：《中国医药科学》2023年第4期193-196,共4页China Medicine And Pharmacy

摘　　要：淋巴瘤是我国最常见的恶性肿瘤之一,依据组织病理学特点,淋巴瘤分为霍奇金淋巴瘤(HL)与非霍奇金淋巴瘤(NHL)两大类,以NHL多见,NHL在我国淋巴瘤中约占87.69%。原发性脾淋巴瘤是一类发生于脾脏的少见肿瘤,一般无脾外脏器和淋巴结受累,其发生率不到淋巴瘤的1%,多为NHL,弥漫大B细胞淋巴瘤是其中最常见的类型,侵袭性强,发病率低。原发性脾淋巴瘤常见于中老年人,临床表现差异性较大,一般表现为非特异性症状,以发热、脾大为多见,可伴有乏力、消瘦、盗汗等,由于临床表现不典型,故临床诊断较困难,极易漏诊、误诊。现报道以肺部感染、肝脓肿为首发表现的原发性脾淋巴瘤1例,本病例以呼吸道症状为首发表现,在诊治的过程中发现肝脓肿,在针对肺部感染及肝脓肿的诊疗过程中,随着病程的变化和对疾病深入的认识,最终确诊为原发性脾淋巴瘤。本病例整个诊治过程复杂,有对临床诊断的不断修正,也有对原发性脾淋巴瘤认识的逐步深入。现将该病例的诊治过程进行报道并行相关文献复习,以提高临床医生对原发性脾淋巴瘤的认识,避免漏诊或误诊。Being one of the most common malignant tumors in China,lymphoma is mainly divided into Hodgkin lymphoma(HL)and non-Hodgkin lymphoma(NHL)based on histopathological characteristics,with NHL being more common and accounting for about 87.69%in overall lymphoma in China.Primary splenic lymphoma is a rare type of lymphoma that occurs in the spleen with the incidence of less than 1%of lymphoma,usually without extra-splenic organ or lymph node involvement.It is mainly NHL,with diffuse large B cell lymphoma being the most common type,highly invasive with low incidence.Primary splenic lymphoma is common in middle-aged and elderly people,and its clinical manifestations are highly variable,generally non-specific symptoms such as common fever and splenomegaly with the possible companion by fatigue,tabescence,and night sweating,etc.There is difficulty in clinically managing this disease due to its atypical clinical manifestations,and it is very easy to be missed and misdiagnosed.This paper herein reports a case of primary splenic lymphoma with pulmonary infection and liver abscess as the initial manifestations,and the patient presented respiratory symptoms first,followed by liver abscess in the process of diagnosis and treatment.This patient was finally diagnosed with primary splenic lymphoma during the treatment of pulmonary infection and liver abscess with the change of disease course and deeper understanding of the disease.The whole diagnosis and treatment process was complex,which involved continuous revision of clinical diagnosis and gradual advancement of understanding of primary splenic lymphoma.Except for reporting the diagnosis and treatment process of this case,relevant literature is reviewed to improve clinicians’understanding of primary splenic lymphoma,so as to avoid missed diagnosis or misdiagnosis.

关 键 词：脾脏 原发性 淋巴瘤 肺部感染 肝脓肿 

分 类 号：R733.2[医药卫生—肿瘤]