原发性脾肿瘤21例临床分析

目的:探讨原发性脾肿瘤的临床特点、诊断及治疗。方法:回顾性分析1990年1月至2005年9月深圳市第二人民医院和华中科技大学同济医院收治的21例原发性脾肿瘤患者的临床资料。结果:21例原发性脾肿瘤均行手术治疗,其中11例良性病变包含脾血管瘤4例、脾表皮样囊肿、脾炎性假瘤各2例,脾错构瘤、脾假性囊肿、脾肉芽肿性病变各1例;10例恶性肿瘤包含脾原发性非何杰金氏淋巴瘤6例,纤维肉瘤2例,血管肉瘤2例。随访,良性肿瘤患者均无复发;6例非何杰金氏淋巴瘤,除1例术后8个月死于复发外,2例分别随访30个月和45个月未发现复发和转移,3例随访超过5年仍健在,其中1例存活已达12年。纤维肉瘤2例,均生存5年无转移。2例脾血管肉瘤分别于手术后3个月和11个月因肿瘤广泛转移而死亡。结论:原发性脾肿瘤以手术治疗为主,良性肿瘤效果好;原发性非何杰金淋巴瘤结合辅助治疗预后好,恶性肉瘤预后差,早期诊断,根治性手术和综合治疗是提高疗效的关键。

Diagnosis and Treatment of 21 Cases of Primary Splenic Tumors

Objective:To study the clinical characteristics,diagnose and treatment of primary splenic tumors.Methods:The clinical data of 21 patients with primary splenic neoplasm from January 1990 to September 2005 were analyzed retrospectively.Results:Eleven cases of benign splenic tumors including 4 cases of hemagioma,2 of splenic true cyst,2 of inflammatory pseudotumor,1 of epidermoid cyst,and 1 of hamartoma and asestoma.There were 10 cases of malignant tumor,among which,there were 6 cases of non Hodgkin's lymphoma,2 of angiosarcoma and 2 of fibrosarcoma.Conclusion:Splenectomy is the first choice of treatment for primary splenic tumors and surgery is satisfactory in benign tumors.Non Hodgkin's lymphoma requires adjuvant therapy.Prognosis of angiosarcoma is bad.Early diagnosis and therapy are crucial to improving the prognosis of primary splenic malignancy.