摘要
目的:探讨原发性肺淋巴瘤的临床表现和诊断。方法:回顾性分析了本院1999年9月-2006年6月诊治的18例原发性肺淋巴瘤的的临床资料,对其临床表现、影像学特点、确诊手段、分期和预后进行分析。结果:18例均为非霍奇金淋巴瘤,其中13例黏膜相关淋巴组织(mucosa-associate lymphoid tissue,MALT)淋巴瘤,3例小B淋巴细胞淋巴瘤,1例间变性大细胞淋巴瘤,1例T细胞非霍奇金淋巴瘤可能性大。临床以咳嗽、体重下降常见,4例无症状因体检发现。CT以肺部实变、结节肿块表现为多,实变影中常见支气管充气征。2例为纤支镜活检病理明确,7例行肺穿的患者仅1例明确。15例经手术病理明确[10例行开胸手术,5例行电视胸腔镜(VATs)]。18例中9例为IE期,4例为Ⅱ1E期,3例为Ⅱ2E期,1例Ⅲ期,1例Ⅳ期。手术切除和放化疗是本病主要治疗手段。结论:原发性肺淋巴瘤临床和影像表现无特征性,因而易误诊,手术活检是主要诊断方法,预后相对较好。
Objective： To study the clinical characteristics and diagnosis of primary pulmonary lymphoma （PPL）. Methods： A retrospective review was performed based on the clinical records of 18 PPL cases treated at Affiliated Pulmonary Hospital of Tongji University from 1999 Sep to 2006 June. The clinical manifestations, imaging features, diagnosis approaches, staging, and prognosis of the 18 patients were analyzed. Results： All the eighteen cases of PPL belonged to the non Hodgkin＇s lymphoma. There were 13 patients with mucosa-associated lymphoid tissue （MALT） lymphoma, 3 patients with small B cell lymphoma, 1 patient with anaplastic large cell lymphoma, and 1 patient with T cell lymphoma tendency. The main symptoms were cough and weight loss. The PPL in 4 patients with non specific symptoms were diagnosed during physical examination. Pulmonary consolidation shadows and multiple nodules were the main findings of CT scan. An air bronchogram is often seen in the consolidation imaging. All the 18 patients received fiber-bronchoscopic biopsy but only 2 patients were diagnosed as PPL. Seven patients were given percutaneous needle biopsy but PPL was confirmed in only 1 patient. The diagnosis was confirmed in fifteen patients by operative pathology. Ten patients received open thoracotomy and 5 patients received video-assisted thoracoscopy. Of the 15 patients, there were 9 cases in stage E,4 cases in stage Ⅱ 1E,3 cases in stage Ⅱ2E,1 case in stage Ⅲ, and 1 case in stage Ⅳ. Surgery, radiotherapy, and chemotherapy were most common treatment modalities for PPL. Conclusion： PPL was easy to be misdiagnosed due to non specific clinical and imaging manifestations. The invasive biopsy is the main diagnosis approach. The prognosis is relatively better.
出处
《肿瘤》
CAS
CSCD
北大核心
2007年第6期496-498,共3页
Tumor
关键词
淋巴瘤
非霍奇金
肺肿瘤
诊断
Lymphoma, non-Hodgkin
Lung neoplasms
Diagnosis
