以腹腔淋巴结肿大为首发表现的淋巴瘤类型构成分析  

Lymphoma types with abdominal lymphadenopathy as the first manifestation

作　　者：张燕林[1] 谢建兰[1] 周小鸽[1] ZHANG Yan-lin;XIE Jian-lan;ZHOU Xiao-ge(Department of Pathology,Beijing Friendship Hospital,Capital Medical University,Beijing 100530,China)

机构地区：[1]首都医科大学附属北京友谊医院病理科,北京100530

出　　处：《诊断病理学杂志》2023年第1期10-13,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的 探讨以腹腔淋巴结肿大为首发表现的淋巴瘤的病理类型及构成特点。方法 回顾性分析216例淋巴瘤的临床资料、病理组织学类型及免疫组织化学染色结果,按《WHO(2017)造血与淋巴组织肿瘤分类》标准进行病理诊断及分类。结果 216例淋巴瘤中,男性139例,女性77例,男女比例为1.8∶1。年龄2~77岁,平均年龄43.5岁,中位年龄41岁。患者均以发现腹腔淋巴结肿大为首发表现就诊。其中121例(56.0%)无伴随症状,在体检时偶然发现;95例(44.0%)患者伴有不同程度的发热(29例,13.4%)、腹胀(68例,31.5%)、盗汗(41例,19.0%)及体重减轻(39例,18.1%)。淋巴结直径1~13 cm,平均6.4 cm。非霍奇金淋巴瘤(NHL)204例(94.4%),霍奇金淋巴瘤(HL)12例(5.6%)。NHL中B细胞来源185例(85.6%),T细胞或NK细胞来源19例(8.8%)。NHL-B细胞来源中,构成比居前3位的分别为滤泡性淋巴瘤(FL)92例(42.6%),弥漫大B细胞淋巴瘤-非特殊类型(DLBCL-NOS)54例(25.0%)、Burkitt淋巴瘤23例(10.6%)。结论 以腹腔淋巴结肿大为首发表现的淋巴瘤以男性多见,滤泡性淋巴瘤是最常见的类型。无论哪种类型,临床症状均不典型,需引起注意,避免漏诊。Objective To investigate the pathological types and clinical features of lymphoma with abdominal lymphadenopathy as the first manifestation. Methods The clinical data, histopathological types and immunohistochemical staining results of 216 cases of lymphoma were analyzed retrospectively. The pathological diagnosis and classification were carried out according to the classification standard of WHO(2017). Results There were 139 males and 77 females, with a male to female ratio of 1.8∶1. The age ranged from 2 to 77 years, with an average age of 43.5 years and a median age of 41 years. The first manifestation of all patients was abdominal lymphadenopathy. Among them, 121 cases(56.0%) had no accompanying symptoms and were found during physical examination;95 patients(44.0%) had fever(29 cases, 13.4%), abdominal distension(68 cases, 31.5%), night sweats(41 cases, 19.0%) and weight loss(39 cases, 18.1%). The diameter of lymph nodes were 1-13 cm, with an average of 6.4 cm. There were 204 cases(94.4%) of non Hodgkin’s lymphoma(NHL) and 12 cases(5.6%) of Hodgkin’s lymphoma(HL). In NHL, 185 cases(85.6%) were derived from B cells and 19 cases(8.8%) from T cells or NK cells. Among the origin of B cells, the top three constituent types were follicular lymphoma in 92 cases(42.6%), diffuse large B-cell lymphoma non special type in 54 cases(25.0%) and Burkitt lymphoma in 23 cases(10.6%). Conclusion Lymphoma with abdominal lymphadenopathy as the first manifestation is more commonly found in men, and follicular lymphoma is the most common type. No matter which type, the clinical symptoms are not typical, which needs the attention of clinicians and pathologists to avoid missed diagnosis.

关 键 词：淋巴瘤 腹腔 病理类型 

分 类 号：R733.4[医药卫生—肿瘤]