原发性肾淋巴瘤3例

原发性肾淋巴瘤(primary renal lymphoma,PRL)罕见。为了探讨PRL的临床特点、诊治和预后,对我院近10年收治的3例原发性肾淋巴瘤进行分析,总结其临床表现、实验室检查、病理特征和病程,以及相应的诊治措施。结果表明:3例男性原发性肾淋巴瘤,发病年龄大于50岁,最常见的症状是腰痛,伴有腹部包块、血尿等,术前均高度怀疑肾癌而予以手术切除,术后病理提示肾淋巴瘤,且都是弥漫B细胞性,细胞表面抗原CD20阳性,应用人源化的抗CD20单克隆抗体联合方案化疗,同时局部进行放疗,治疗间歇辅予干扰素,并加强支持治疗,其中2例生存超过5年。结论:原发性肾淋巴瘤极少见,临床易误诊,早期确诊和个体化治疗可望改善预后。

Three Cases of Primary Renal Lymphoma

Primary renal lymphoma (PRL) is very rare. In order to investigate the clinical features, diagnosis, therapy and prognosis of PRL, three cases of primary renal lymphoma diagnosed definitely and treated in our hospital in the recent ten years were reported, and their clinical features, laboratory examination, pathological observation and their therapeutics were analyzed. The results indicated that the three cases of primary renal lymphoma were all male elders. Their most common symptoms were flank pain along with abdominal mass and hematuria, etc. Becanse of suspicion of cancer with renal involvement, the three patients all underwent laparotomy. Histological examination showed diffuse B-cell lymphoma in the three cases, and the immunophenotype was CD20 positive in all three cases. These cases were treated with combinated therapeutics, including rituximab, intermittent interferon and local radiotherapy. The 2 out of 3 cases lived for more than 5 years after therapy. In conclusion, as PRL is especially rare, and often diagnosed mistakenly, it is suggested that early and definite diagnosis and individualization of treatment for PRL patients may be possible to achieve a better therapeutic result.