儿童泌尿系非霍奇金淋巴瘤2例报告  

Two case reports of pediatric urinary non-Hodgkin lymphoma

作　　者：梁海燕[1] 宋宏程[1] 姚兴凤[2] 王蓓[3] 李宁[1] 张潍平[1] 孙宁[1] Liang Haiyan;Song Hongcheng;Yao Xingfeng;Wang Bei;Li Ning;Zhang Weiping;Sun Ning(Department of Urology,Beijing Children's Hospital of Capital Medical University,National Children’s Medical Center,Beijing 100045,China;Department of Pathology,Beijing Children's Hospital of Capital Medical University,National;Department of Radiology,Beijing Children's Hospital of Capital Medical University,National Children’s Medical Center,Beijing 100045,China)

机构地区：[1]国家儿童医学中心、首都医科大学附属北京儿童医院泌尿外科,北京100045 [2]国家儿童医学中心、首都医科大学附属北京儿童医院病理科,北京100045 [3]国家儿童医学中心、首都医科大学附属北京儿童医院影像中心,北京100045

出　　处：《中华泌尿外科杂志》2025年第1期65-66,共2页Chinese Journal of Urology

摘　　要：儿童泌尿系非霍奇金淋巴瘤较为少见,以肾或输尿管单发肿瘤伴多发淋巴结、骨转移就诊时极易误诊为泌尿系原发肿瘤晚期,从而行根治性肾切除术。本文报道2例以泌尿系单发结节为表现的淋巴瘤。例1,因发热、乏力,检查发现右肾占位就诊,CT、PET-CT检查示多发骨质破坏、淋巴结转移。行肾穿刺活检,诊断为ALK阳性间变性大细胞淋巴瘤。化疗6个月,肾脏瘤灶消失,疗效显著。例2,因间断腹痛、发现左肾积水就诊,超声检查示左肾积水、输尿管扩张,输尿管下段条状低回声占位。术前患儿出现突发视物模糊,行MRI检查发现右视神经框内占位,PET-CT检查示多发骨、淋巴结、多发神经侵犯;行淋巴结穿刺活检,诊断为Burkitt淋巴瘤。化疗、放疗6个月,影像学检查显示输尿管占位消失,肾积水消失;腹部淋巴结、颈部淋巴结均明显缩小。Pediatric urological non-Hodgkin lymphoma is relatively rare.When a single renal or ureteral tumor with multiple lymph node or bone metastases is present,it is very easy to be misdiagnosed as urinary tumor with metastasis,resulting in unnecessary radical nephrectomy.This paper reports two cases of non-Hodgkin lymphoma presenting with single urinary nodules.Case 1 was diagnosed with a 4.5cm tumor in the right kidney due to fever and fatigue.CT and PET-CT showed multiple bone destruction and lymph node metastasis.Renal biopsy was performed and ALK-positive anaplastic large cell lymphoma was diagnosed.Chemotherapy was effective for 6 months.Case 2 was diagnosed with left hydronephrosis due to intermittent low back pain for 2 weeks.Ultrasound examination revealed ureteral dilation with left hydronephrosis and low echo occupying of the lower ureter.The patient had sudden blurred vision before surgery.MRI examination revealed space occupying in the right optic nerve frame,and PET-CT found multiple bone,lymph nodes and nerve invasion.A lymph node biopsy was performed and Burkitt lymphoma was diagnosed.After 6 months of chemotherapy and radiotherapy,the tumor shrank significantly.

关 键 词：淋巴瘤 非霍奇金 儿童 单发泌尿系统肿物 

分 类 号：R737.1[医药卫生—肿瘤]