摘要
目的分析总结本院以肺部病变首诊的弥漫性大B细胞淋巴瘤(DLBCL)的临床特点,以提高对该病的认识。方法回顾性分析2007年5月～2017年8月我院收治的17例以肺部病变首诊的DLBCL患者的临床资料,分析和总结其临床特点、实验室相关指标检查情况、影像学特点、误诊情况、病理学特点、治疗及预后。结果 17例患者中,男女比例接近1∶1,平均年龄(54.4±15.7)岁;患者主要症状表现为咳嗽、咳痰、气喘、发热等;实验室检查可见部分患者血清乳酸脱氢酶(LDH)、神经元特异性烯醇化酶(NSE)升高;胸部CT表现为肺内肿块结节影、渗出影、弥漫小结节、磨玻璃浸润影、肺不张等多种病变形态;所有患者均行组织病理学确诊:4例行支气管镜黏膜活检,4例行CT引导下经皮肺穿刺活检,9例行淋巴结活检。结论以肺部病变首发表现的DLBCL临床缺乏特异性,影像学表现呈多样性,确诊需完善病理学检查,以利于早期治疗,改善预后。
Objective To analyze and summarize the clinical features of diffuse large B cell lymphoma(DLBCL),which was first diagnosed as pulmonary lesions,in order to improve the understanding of DLBCL.Methods A retrospective analysis was made of the clinical data of 17 cases of DLBCL with pulmonary lesions first diagnosed in our hospital from May 2007 to August 2017,the clinical characteristics,laboratory examination,imaging characteristics,misdiagnosis,pathological characteristics,treatment and prognosis were analyzed and summarized.Results Among the 17 patients,the ratio of male to female was close to 1:1,with an average age of(54.4±15.7)years.The main symptoms were cough,sputum,asthma and fever.Lactate dehydrogenase(LDH)and neuron specific enolase(NSE)were increased in some patients.Thoracic CT manifestations included nodular,exudative,diffuse nodules,ground glass infiltration,atelectasis and other pathological changes.All patients were confirmed by histopathology.Bronchoscopic mucosal biopsy was performed in 4 cases,CT-guided percutaneous lung biopsy in 4 cases and lymph node biopsy in 9 cases.Conclusion The clinical manifestations of DLBCL,which is the first manifestation of pulmonary lesions,are lack of specificity,and the imaging manifestations are diverse.It is necessary to improve the pathological examination in order to facilitate early treatment and improve the prognosis.
作者
张祥娥
黄颂平
叶晓艺
沈冰寒
ZHANG Xiang-e;HUANG Song-ping;YE Xiao-yi;SHEN Bing-han(Department of Respiratory Medicine,Quanzhou First Hospital Affiliated to Fujian Medical University,Fujian Province,Quanzhou 362100,China)
出处
《中国当代医药》
2019年第1期48-51,共4页
China Modern Medicine
关键词
弥漫性大B细胞淋巴瘤
影像学
诊断
治疗
Diffuse large B cell lymphoma
Imageology
Diagnosis
Treatment
