摘要
目的探讨原发性胰腺淋巴瘤(PPL)的临床特点以及诊疗体会。方法回顾性分析5例原发性胰腺淋巴瘤的临床资料。结果本组5例患者中病灶位于胰头部3例,胰体尾2例。临床表现包括上腹痛、黄疸、发热、盗汗,体重减轻等。其中一例CA19-9增高,其余肿瘤指标均处于正常范围。影像学检查均示胰腺癌可疑,2例行剖腹探查术、组织活检,2例行胰十二指肠切除术,1例行外周浅表淋巴结活检,均诊断为胰腺非霍奇金淋巴瘤。术后5例患者均予以CHOP(环磷酰胺、阿霉素、长春新碱、泼尼松)方案化疗。结论原发性胰腺淋巴瘤临床症状不典型,极易与胰腺癌混淆,影像学对诊断有提示作用,最终的诊断需要依靠病理学检查。治疗手段为手术切除术后加以化疗,无法切除的患者仅行化疗。胰腺原发淋巴瘤的预后明显优于胰腺癌。
Objective To probe the clinical characteristics of primary pancreatic lymphoma（PPL） and the experience in the diagnosis and treatment of PPL. Methods The clinical data of 5 PPL cases diagnosed and treated in the First Hospital of ChangZhou from October 2000to October 2009was retrospectively analyzed. Results In three cases the pancreatic mass was located in the head of the pancreas, and in the remaining two cases the mass was located in the body or tail. The presenting symptoms were as follows： epigastric pain, jaundice, fever at night, sweats and chills ,weight loss and so on. One case had the elevation of CA 19.9. The other tumor marker levels were all within the normal range. Two cases underwent exploratory laparotomy and was biopsied. Two cases underwent pancreaticoduodeneetomy. One case un- derwent lymph node puncture. They were all diagnosed as non - Hodgkin lymphoma. They all underwent chemotherapy. Conclusion Due to the uncharacteristic clinical symptoms, it is difficulty to distinguish PPL from the pancreatic cancer. Imaging examination can provide im- portant information for diagnosis. Chemotherapy is main therapy for PPL. The utimate diagnosis depends on pathological examination. The main therapy is combination of surgical treatment with chemotherapy. While the mass resection is impossible, chemotherapy turns out to be the main therapy. PPL has a much better prognosis than pancreatic cancer.
出处
《临床肝胆病杂志》
CAS
2011年第11期1190-1192,共3页
Journal of Clinical Hepatology
关键词
胰腺肿瘤
淋巴瘤
诊断
治疗
Pancreatic neoplasm Lymphoma Treatment Diagnosis
