原发扁桃体非霍奇金淋巴瘤21例临床分析

目的 探讨原发扁桃体非霍奇金淋巴瘤（NHL）的临床病理特征、诊断治疗及预后。方法 回顾性分析天津医科大学总医院2007年1月—2014年1月收治的经病理确诊的21例原发扁桃体NHL的临床资料，总结其临床病理特点、分期及预后。结果 21例原发扁桃体NHL占同期行扁桃体手术病理患者的2.6%（21/807）。其中男13例，女8例，平均发病年龄（50.8±12.9）岁。单侧发病19例（90.5%）。病理学诊断源于B细胞20例（95.2%），其中弥漫大B细胞型13例（61.9%），滤泡性4例（19.0%），套细胞型3例（14.3%）；源于T细胞1例（4.8%）。按照Ann-Arbor标准分期Ⅰ~Ⅱ期18例，5年生存率为71.4%；Ⅲ~Ⅳ期3例，5年生存率为0。结论 原发扁桃体NHL较为罕见，早期患者预后较好，重视本病的早期诊断、早期治疗是提高5年生存率的关键。

Clinical analysis of 21 primary non-Hodgkin's lymphoma of the tonsil

Objective To investigate the clinical and pathological features, treatment and prognosis in primary nonHodgkin's lymphoma (NHL) of the tonsil. Methods Data of 21 patients with tonsil NHL treated in Tianjin MedicalUniversity General Hospital from Jan 2007 to Jan 2014 were retrospectively analyzed. Results A total of 21 cases oforiginal tonsil NHL accounted for 2.6% (21/807) of pathological diagnosis of tonsil surgery during the same period. Therewere 13 males and 8 females, the mean age was（50.8±12.9）years old. The unilateral disease were 19 cases (90.5%). Thepathological classification: 20 cases (95.2%) were B-cell subtype including diffuse large B-cell lymphoma (DLBCL) 13cases (61.9%), follicular lymphoma (FL) 4 cases (19.0%) and mucosa associated lynmphoid tissue (MALT) 3 cases (14.3%);1 case was T-cell subtype (4.8%). According to the Ann-Arbor standard, 18 cases (85.7%) were stage Ⅰ-Ⅱ, 3 cases(14.3%) were stage Ⅲ - Ⅳ . The 5 year survival of stage Ⅰ - Ⅱ patients was 71.4%, of stage Ⅲ - Ⅳ patients was 0%.Conclusion Primary tonsil NHL is rare and the prognosis at early stages is good. The key to improve the 5-year survivalrate is to pay attention to the early diagnosis and treatment of the disease.