淋巴瘤的治疗进展

淋巴瘤是一组起源于淋巴结和其他淋巴组织的恶性肿瘤，近年来其发病率有逐年增高的趋势。关于淋巴瘤的治疗WHO新分类建议对每一种类型采取不同的治疗策略。本文主要介绍国内外关于淋巴瘤治疗的最新进展。     

浆细胞淋巴瘤

本文收集11个单位原诊断为小淋巴细胞性、淋巴浆细胞性、浆细胞性以及FCC 淋巴瘤伴浆化的病例,对其病理切片进行回顾性观察,选出83例符合浆细胞淋巴瘤的病例分成五个类型:①淋巴浆细胞性、②淋巴浆细胞样、③浆细胞性、④前浆细胞性、⑤浆母细胞性淋巴瘤。本组病例常见的部位为淋巴结及消化道,其次是上呼吸道、神经系统及眼眶。其中12例有随访结果,提示浆母细胞性淋巴瘤的预后较差。     

原发性肺淋巴瘤临床特点分析

回顾性分析1999年1月至2009年12月经病理学证实的13例原发性肺淋巴瘤患者的临床资料.其中8例为黏膜相关性淋巴组织来源的边缘带淋巴瘤,2例为弥漫大B细胞型非霍奇金淋巴瘤,1例为NK/T细胞型非霍奇金淋巴瘤,1例为结节硬化型霍奇金淋巴瘤,1例为淋巴细胞为主型霍奇金淋巴瘤.临床症状多表现为咳嗽、发热、盗汗或体重减轻,2例无症状.CT检查多表现为肺内肿块,实变影中常见支气管充气征.5年总生存率9/13,其中黏膜相关性淋巴组织来源的边缘带淋巴瘤型的5年生存率7/8.     

从两例恶性淋巴瘤的误诊谈恶性淋巴瘤与假性淋巴瘤的病理鉴别诊断

例1男,21岁。1989年10月阴茎发生红斑及皮下结节性损害,皮损逐渐肿大,继而局部坏死和形成溃疡。腹股沟淋巴结肿大,伴发热。先后在太原市两所医院诊治。曾取活体组织病理检查,诊断为“结节性血管炎”。多种抗菌素及强的松等药物治疗无效,且躯干和四肢也相继发生类似的皮损。于1990年8月患者赴北京某医院就诊,曾先后在阴茎、躯干和下肢等部位皮肤取活体组织检查,分别诊断为“结节性血管炎”和“Wegenr’s肉芽肿病?”。由于阴茎严重环死,作了阴茎全切术。术后返回太原,于1991年3月来我院就医。取活体组织病理检查,诊断为恶性淋巴瘤(诊断依据见本文讨论部分),将患者转诊到肿瘤医院抗癌治疗,后死于1992年4月。     

恶性淋巴瘤患者脑脊液中查见淋巴瘤细胞1例

患男，l3岁，1998年12月无明显诱因出现左颈部淋巴结肿大，伴胸闷、气急、颜面浮肿．无发热、盗汗及咳嗽。胸部影像学检查示胸膜部有一肿大淋巴结。颈部淋巴结活检经病理检查诊断为非霍奇金淋巴瘤(B细胞，弥漫型)．即予CHOP方案化疗。1999年7月行自体造血干细胞移植，同     

伯基特氏淋巴瘤2例

伯基特(Burkitt)氏淋巴瘤是高发于中部非洲儿童的一种低分化恶性淋巴瘤,国内少见,仅有散在个例报告,现将我们见到的2例介绍如下。1 病例介绍患者耿某,男性,10岁。因颌面部肿瘤20余日于1995年1月8日入院。20日前,患者感左下颌骨疼痛,继之左面部及颌下肿胀疼痛,并且逐渐加重而就诊。查体:贫血貌,肝胆脾未见明显异常,全身浅表淋巴结未肿大。双侧面部及左颞部弥漫性肿胀,左侧为重,质硬,压痛明显;双颌下可触及表面为4.0cm×4.0cm、1.5cm×1.5cm之肿块,质硬、固定、压痛明显。全口牙龈肿胀,疼痛,多个后牙松动。B超检查提示颌下区脓肿,初诊:颌面间隙感染并颌下淋巴结炎。在局麻下行左颊部口内切开排脓。取活检,切开见肿瘤组织质脆、灰白色、呈鱼肉样改     

腺淋巴瘤一例

腺淋巴瘤一例谭天祚，张鑫患者男，６６岁。１０年前见左耳垂下方肿块如蚕豆大小，生长缓慢；近期已大如鸡蛋，颈部活动受限，于１９９１年５月１７日入院手术治疗。检查：肿块处皮色正常，上界位置较深，边缘不清，下界较浅可移动，无明显压痛及不适；波动感（±）。肿块...     

中医药治疗恶性淋巴瘤近况

中医药治疗恶性淋巴瘤近况牛孺子，李应存图书馆１．辨证论治与临床分型根据临床经验认为本病病机主要表现为痰结和正虚，故临床多见以脾虚痰凝，热痰蕴结，气血两虚等分型论治。如周岱翰氏［１］将木病分为①脾湿痰凝型：治以健脾祛湿，除痰散结，用四君子汤合夏枯草、苡...     

Lennert's lymphoma

Lymphoepithelioid cell lymphoma Lennert's Lymphoma is a rare morphological variant of peripheral T-cell lymphoma characterized by the presence of numerous clusters of epithelioid histiocytes without formation of discrete granulomas and the intervening atypical lymphocytes. Lennert's lymphoma is often misinterpreted as granulomatous lymphadenitis or Hodgkin's disease. This report describes fine needle aspiration cytology and histological findings in a case of Lennert's lymphoma.     

Molecular diagnosis of malignant lymphoma: mantle cell lymphoma, anaplastic large cell lymphoma, and marginal zone B-cell lymphoma of malt

Malignant lymphoma is a heterogeneous category embracing three major types of lymphoid neoplasms: B cell neoplasms, T and NK cell neoplasms, and Hodgkin lymphoma. Within each type, distinct disease entities are defined based on a combination of morphology, immunophenotype, genetic features and clinical syndromes, the emphasis on which represents a new paradigm in the lymphoma classification of the World Health Organization (WHO). These lymphoma entities often have distinctive cytogenetic abnormalities, usually involving translocations that place a potential cellular oncogene under the influence of the immunoglobulin in some low-grade B-cell lymphomas. Both pathologists and oncologists are now concerned with better understanding each disease entity and its spectrum of morphology, genetic events, and clinical behaviors. Over the last decade, significant progress has been made in the molecular characterizations of mantle cell lymphoma, anaplastic large cell lymphoma, and marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), which have not only provided insights into the pathogenesis of lymphomas, but also valuable data that could lead to therapies based on their clinical behavior.     

恶性淋巴瘤患者自身混合淋巴细胞反应水平的检测

Human T cells can be induced to proliferate in vitro when they are cocultured with autologous Non-T cells. This phenomenon has been termed the autologous mixed lymphocyte reaction, AMLR. In this study, AMLR was assessed in 14 untreated patients with lymphoma and 13 age-and-sex-matched healthy controls. This difference was significant (P less than 0.001), suggesting that patients with lymphoma may have impaired AMLR.     

Isolated conjunctival lymphoma metastasis from previous low grade non-Hodgkin's lymphoma

Ocular involvement of systemic non-Hodgkin's lymphoma is rare. This report describes the unusual occurrence of a biopsy confirmed low grade lymphoma recurring in the conjunctiva, three years after initial diagnosis of systemic disease. The tumour was surgically resected and the patient remains disease free four years later. After the diagnosis of lymphoma, long term follow up is advised as recurrences in unusual sites can occur.     

原发于甲状腺的恶性淋巴瘤

目的探讨原发于甲状腺的恶性淋巴瘤的临床过程。方法分析、总结4例原发于甲状腺的恶性淋巴瘤病人的治疗过程，并复习相关文献。4例病人中男性1例．女性3例。年龄均〉60岁。Ⅰ期3例，Ⅱ期1例。均为B细胞来源。4例患者均接受了手术、化疗和放疗的综合治疗。2例行甲状腺全切除术，1例行甲状腺次全切除术，1例行肿瘤活检术。化疗方案采用CHOP方案，放疗量44-56GY，中位剂量50GY。结果1例患者放疗后2a死于肿瘤全身广泛侵犯。另3例患者至今仍无瘤生存，生存期分别为4、6及7a。均长期口服甲状腺片，2例出现甲状腺功能减低。结论原发于甲状腺的恶性淋巴瘤主要为B细胞来源的非霍奇金淋巴瘤，治疗宜采取综合治疗。年龄及期别影响其预后。