236 例原发性结外淋巴瘤临床和病理分析简

本研究探讨原发性结外淋巴瘤（primary extranodal lymphoma,PENL）的临床和病理特征.回顾性分析北京大学第一医院2001年1月至2012年3月收治的经病理和免疫组织化学确诊的236例PENL的临床和病理特点.结果表明：①236例PENL病例占同期淋巴瘤的40.7％ （236/580）,中位年龄为55岁（16岁-91岁）,男女性别比例为1.8： 1（153/83）.②PENL的首发部位常见于胃肠道、鼻腔、扁桃体、纵隔、皮肤、脾、睾丸、骨及软组织、中枢神经系统,其所占比例依次为30.1％（71/236）、10.6％ （25/236）、8.9％ （21/236）、5.9％ （14/236）、5.1％ （12/236）、4.7％（11/236）、4.2％ （10/236）、4.2％ （10/236）、3.0％ （7/236）.③PENL的首发症状多无特异性;体征多为原发器官的肿大或局部肿块形成,在本研究中此体征占66.9％（158/236）.④按照2008年WHO造血和淋巴组织肿瘤分类,胃肠道PENL病理类型以弥漫性大B细胞淋巴瘤、MALT淋巴瘤常见,鼻腔PENL病理类型以结外NK/T细胞淋巴瘤常见,扁桃体、睾丸、中枢神经系统PENL病理类型以弥漫性大B细胞淋巴瘤常见.结论：原发性结外淋巴瘤并不少见,出现原发器官的肿大或局部肿决形成时,应警惕原发性结外淋巴瘤,重视病理组织学检查.

Clinical and Pathological Analysis of 236 Patients with Primary Extranodal Lymphoma

This study was aimed to analyze the clinical and pathological characteristics of patients with primary extranodal lymphoma （PENL）.A total of 236 patients with PENL were enrolled to evaluate the clinical and pathological features.The clinical data of 236 patients with PENL confirmed by pathological and immunohistochemical methods between January 2001 and March 2012 were analyzed retrospectively.The results indicated that：（1）236 patients with PENL accounted for 40.7％ of lymphoma over the same period.Median age was 55 years old（from 16 to 91 years old）.There were 153 males and 83 females（ratio 1.8∶1）.（2）The common sites of involvement were gastrointestinal tract,nasal cavity,tonsil,mediastinum,skin,spleen,testis,bone and soft tissue,central nervous system,which accounted for 30.1％ （71/236）,10.6％ （25/236）,8.9％ （21/236）,5.9％ （14/236）,5.1％ （12/236）,4.7％ （11/236）,4.2％ （10/236）,4.2％ （10/236）,3.0％ （7/236） respectively.（3） Symptoms of PENL did not have special characteristics,however its signs usually manifested with the enlargement or mass of organs,which accounted for 66.9％ （158/236） in this study.（4）According to WHO classification of tumnours of haematopoietic and lymphoid tissues in 2008,the common pathological type of gastrointestinal lymphoma was diffuse large B-cell lymphoma,mucosaassociated lymphoid tissue lymphoma; the common pathological type of nasal lymphoma was extranodal NK/T cell lymphoma; the common pathological type of tonsillar lymphoma、testicular lymphoma、CNS lymphoma was diffuse large B-cell lymphoma.It is concluded that the primary extranodal lymphoma is not rare,it is alert to PENL while organs enlarge or mass forms,so that clinical physician should pay attention to tissue biopsy.