肾上腺淋巴瘤临床特点及预后分析

目的总结肾上腺淋巴瘤患者临床特点及治疗转归，提高临床医师对其认识。方法对我院1995—2012年确诊的22例肾上腺淋巴瘤患者的临床资料进行回顾性分析，并对其治疗转归进行随访。结果男：女为15：7，年龄（55．63±13．74）岁，就诊时病程11d～7个月。原发性肾上腺淋巴瘤9例，继发性肾上腺淋巴瘤13例，病理分型非霍奇金淋巴瘤21例，霍奇金淋巴瘤1例。主要临床表现为发热、腹痛、腰痛、体重减轻、皮肤色素沉着、疲乏无力、食欲减退。21例病理分型为大B细胞型非霍奇金淋巴瘤，术后给予环磷酰胺＋阿霉素＋长春新碱＋泼尼松（CHOP方案）化疗；1例肾上腺霍奇金淋巴瘤，给予阿霉素＋博莱霉素＋长春花碱＋达卡巴嗪（ABVD方案）化疗；18例死亡，随访生存期〈1年。结论肾上腺淋巴瘤病变累及双侧。肾上腺时可出现肾上腺皮质功能低下，确诊需依靠穿刺或手术病理，预后较差，生存期多〈1年。

Clinical features and outcomes of adrenal lymphoma

Objective To improve the understanding of adrenal lymphoma in clinicians by summarizing its clinical features and outcomes. Methods The clinical data about 22 patients with adrenal lymphoma （15 males and 7 females） at the age of 55.63 ~ 13.74 years admitted to our hospital from 1995 to 2012 were retrospectively analyzed. The patients were followed up. Results The course of adrenal lymphoma was 11 days-7 months when the patients visited our hospital. Of the 22 patients, 9 were diagnosed with primary adrenal lymphoma and 13 with secondary adrenal lymphoma, 21 were typed as non-Hodgkin＇s adrenal lymphoma and 1 as Hodgkin＇s adrenal lymphoma. The main symptoms were manifested as fever, abdominal and back pain, loss of body weight, skin pigmentation, weakness and aneroxia. Non-Hodgkin＇s B-cell adrenal lymphoma received CHOP therapy and Hodgkin＇s adrenal lymphoma underwent ABVD therapy after operation. Eighteen patients died with a follow-up survival time of less than 1 year. Condusion The adrenocortical insufficiency may occur in patients with adrenal lymphoma with bilateral adrenal glands involved. Its diagnosis depends on acupuncture or pathological examination. The prognosis of adrenal lymphoma patients is poor. The survival time of such patients is usually less than 1 year after operation.