31例胃肠道淋巴瘤临床病理学研究

本文分析了31例胃肠道淋巴瘤的临床及病理学研究。男性发病高于女性，平均年龄56．6岁，发生部位以胃最为常见占77％（24／31），小肠、回盲肠及盲肠、大肠各2例，直肠1例，临床症状无特异性。病理学以裂、无裂细胞淋巴瘤多见。对16例采用免疫组化染色证实B细胞性恶性淋巴瘤占94％（5／16），T细胞性恶性淋巴瘤1例为6％。     

33例小肠非霍奇金淋巴瘤治疗分析

目的探讨小肠非霍奇金淋巴瘤的临床特点、诊断、治疗和预后。方法回顾性分析33例小肠非霍奇金淋巴瘤，其中滤泡型裂细胞性2例，弥漫型裂细胞性7例，弥漫型裂-无裂细胞性5例，弥漫型无裂细胞性6例，免疫母细胞性1例，黏膜相关淋巴组织淋巴瘤2例，弥漫性大B细胞淋巴瘤9例，另有1例为T细胞淋巴瘤。Ann Anbor分期ⅠE期12例，ⅡE期15例，ⅣE期6例。手术治疗33例，29例行根治术，另4例行姑息性切除术。26例行术后放疗，移动条照射12例，全腹盆腔大野照射14例；中位总剂量2543．5cGy。术后化疗33例，其中CHOP方案17例，COMP方案6例，COP方案3例，MINE方案2例，COPP方案3例，BACOP方案2例。结果5年总生存率和无病生存率分别为48％和39％，中位值分别为47、23个月。各期的生存率分别为ⅠE期42％，ⅡE期67％，ⅣE期17％。结论小肠淋巴瘤多为ⅠE、ⅡE期，病理以中、高度恶性为主，治疗多采用以手术为主的综合治疗，术后放疗及化疗可提高生存率。     

8例卵巢非霍奇金淋巴临床分析

[目的]探讨卵巢非霍奇金淋巴瘤（NHL）的临床表现、诊断、治疗及预后。[方法]8例临床资料的回顾性分析。[结果]本组病例占同期卵巢恶性肿瘤0.51%(8/1552)，继发5例，原发3例，按FIGO分期Ⅰ期1例，Ⅱ期1例，Ⅲ期3例，Ⅳ期2例，1例未行手术分期不明，病理类型均属非霍奇金淋巴瘤，B细胞性，裂-无裂细胞、混合细胞、小细胞各2例，大无裂及中心细胞各1例，本组单纯化疗1例，余7例均采用综合治疗，随访结果5例死亡，生存期1-21个月，3例存活，[结论]对于青壮年卵巢肿瘤患者，如肿瘤呈实性、双侧性且伴有CA125增高者，应警惕卵巢淋巴瘤的可能；治疗多采用手术和化疗为主的综合治疗；原发较继发预后好，但原发甚罕见。     

8例卵巢非霍奇金淋巴瘤临床分析

[目的]探讨卵巢非霍奇金淋巴瘤 (NHL)的临床表现、诊断、治疗及预后。 [方法]8例临床资料的回顾性分析。 [结果]本组病例占同期卵巢恶性肿瘤 0.51％ (8/1552)，继发 5例，原发 3例。按 FIGO分期Ⅰ期 1例，Ⅱ期 1例，Ⅲ期 3例，Ⅳ期 2例， 1例未行手术分期不明。病理类型均属非霍奇金淋巴瘤， B细胞性，裂 无裂细胞、混合细胞、小细胞各 2例，大无裂及中心细胞各 1例。本组单纯化疗 1例，余 7例均采用综合治疗。随访结果 5例死亡，生存期 1～ 21个月， 3例存活。 [结论]对于青壮年卵巢肿瘤患者，如肿瘤呈实性、双侧性且伴有 CA125增高者，应警惕卵巢淋巴瘤的可能；治疗多采用手术和化疗为主的综合治疗；原发较继发预后好，但原发甚罕见。     

软组织淋巴瘤的临床病理特征

本文对我科800余例淋巴瘤中8例软组织淋巴瘤从临床及病理组织学方面进行了分析。部位上臂3例、前臂2例、胸壁2例、下肢1例。临床均以无痛性包块而就诊,病程从1周至3个月。8例中有6例位于骨骼肌内,2例位于皮下结缔组织中。手术切除时大小从2.5×2cm至12×6cm之间。病理组织学上均为非何杰金氏淋巴瘤,均呈弥漫型。细胞形态上为淋巴母细胞性1例、淋巴浆细胞样1例、裂细胞性3例、无裂细胞性1例、裂无裂混合性2例。     

100例恶性淋巴瘤的临床分析

目的 观察恶性淋巴瘤患者的骨髓象，了解骨髓侵犯与临床分期、病理、血尿β2－MG、血LDH、外周血象及预后等的关系。方法：对100例恶性淋巴癌患者的骨髓象作分类比较。结果 骨髓侵犯率18％，以Ⅲ、Ⅳ期具有B组症状患者为主；病理以弥漫型小淋巴细胞性、裂－无裂细胞性、无裂细胞性多见。初诊时血尿β2－MG、血LDH升高者、外周血象异常者易发生骨髓侵犯。结论 恶性淋巴瘤患者发生骨髓侵犯者预后不良。     

175例鼻腔非何杰金淋巴瘤临床病理及免疫组化分析

目的：探讨鼻腔非何杰金淋巴瘤（NHL）的临床病理及免疫级化特点。方法：收集本院175例鼻腔NHL的临床病理资料并利用免疫组化（ABC法）进行分析。结果：本组病例男女性别之比为3.5：1，平均年龄46.6岁，其中T细胞性淋巴瘤146例（占83％）；B细胞性淋巴瘤29例（占17％）。100例免疫组化标记，瘤细胞表达T细胞分化抗原的有81例；表达B细胞分化抗原有19例；无一例肿瘤细胞表达Mac-387、LYS、AAT。结论：鼻腔NHL以高度恶性T细胞性为多见，且临床情况特殊，真正的组织细胞性淋巴瘤非常罕见。     

非何杰金淋巴瘤组织形态的转变及其临床意义

 1987～1994年间具有二次活检的非何杰金淋巴瘤患者23例,其中6例发生组织形态的转变。二次活栓间隔时间12～54个月,平均33个月。临床上主要由局部淋巴结肿大或局部器官病变发展成全身淋巴结肿大并伴发热、皮疹或器官受累。临床分期由Ⅰ期发展为Ⅱ～Ⅳ期。组织形态的转变:3例滤泡型变为弥漫型;3例小裂细胞性变为裂一无裂细胞性;1例裂一无裂细胞性变为大无裂细胞性;1例B小淋巴细胞性变为免疫母细胞性。这说明淋巴瘤在疾病的发展过程中可发生组织形态的转变,由低度恶性向高度恶性发展。     

151例弥漫型大无裂细胞性非霍奇金淋巴瘤临床分析

目的　探讨弥漫型大无裂细胞性非霍奇金淋巴瘤的恶性程度。方法　回顾性分析１５１例弥漫型大无裂细胞性非霍奇金淋巴瘤的临床资料。原发部位在淋巴结内６７ 例,原发韦氏环５６ 例,原发结外２８ 例。 Ａｎｎ Ａｒｂｏｒ 临床分期：Ⅰ期４１ 例,Ⅱ期６８ 例,Ⅲ期１８ 例,Ⅳ期２４ 例。单纯放射治疗３２ 例,单纯化疗２１ 例,综合治疗９８ 例。有８ 例患者治疗不足量。结果　１５１ 例中失随７ 例,随访率９５ ．４ ％ 。首程治疗达完全缓解７７ 例,部分缓解５６ 例,无变化６ 例,进展１２ 例。５ 年生存率为４７ ．２ ％ ,而同期１６７ 例中度恶性、９４ 例高度恶性非霍奇金淋瘤分别为５９ ．４ ％ 和４８ ．７ ％ 。结论　弥漫型大无裂细胞性非霍奇金淋巴瘤归入高度恶性较为合适。     

乳腺原发性恶性淋巴瘤四例

乳腺原发性恶性淋巴瘤属于结外型恶性淋巴瘤，临床相当少见。现将我们所遇4例报道如下。临床资料见表。病理变化本组4例，肿瘤均位于乳腺组织内，呈结节状或分叶状，边界清楚者3例，不清楚1例。切面均为灰白色均质、鱼肉状，其中例2肿瘤切面伴灶性出血。镜下见瘤细胞弥漫性浸润乳腺小叶及周围脂肪组织和结缔组织，未累及皮肤。送检腋窝淋巴结2例，1例见瘤细胞侵犯，另1例淋巴结显示反应性增生。本组4例按成都会议分类，弥漫性无裂细胞性3例，淋巴母细胞性1例。免疫组化染色，3例L26阳性、1例L26阴性。讨论乳腺原发性恶性淋巴瘤占乳腺恶性肿…     

A Collaborative Nationwide Lymphoma Study in Lebanon: Incidence of Various Subtypes and Analysis of Associations with Viruses

Incidence of various Hodgkin (HL) and non-Hodgkin lymphoma (NHL) subtypes and association with viruses in Lebanon are not known. We undertook a nationwide study of 272 patients diagnosed with lymphoma in 2007. HL comprised 32.7 % (n?=?89) of cases while NHL represented 67.3 % (n?=?183). Consistent with the literature, nodular sclerosis was the most predominant HL subtype (n?=?57/89). Among NHL, B-cell NHL represented 88 % (n?=?161/183), T-cell NHL 9 % (n?=?17/183), whereas in 2.7 % it was not classifiable. The B-cell NHL comprised predominantly diffuse large B-cell lymphoma (46 %) and follicular lymphoma (23 %). 81 cases were reviewed by a panel of pathologists with 87.6 % concordance rate. Serology was negative for hepatitis C in 122 tested cases. HIV was positive in 2 cases. Two adult T-cell leukemia/lymphoma were HTLV-I positive. EBV IgG were positive in 88.5 % of cases. 38 EBV seropositive cases [27 NHL (24 B-cell, 3 T-cell) and 11 HL] were studied for EBV genome expression using EBV-encoded RNA (EBER)-in situ hybridization. EBER expression was positive in 8 (21 %) cases (6 HL, 2 T-cell NHL). The distribution of lymphoma subtypes in Lebanon appears similar to that of Western countries. The high rate of EBV positivity in HL and T-cell lymphoma by EBER deserves further investigation.     

Biological characteristics and prognosis of childhood malignant lymphoma

The biological characteristics and prognosis of childhood malignant lymphoma were reviewed. A national survey of 568 cases of childhood malignant lymphoma in Japan revealed that 505 cases (88.9%) were non-Hodgkin's lymphoma (NHL), and 63 cases (11.1%) were Hodgkin's lymphoma (HL). The biological characteristics of NHL in Japan were a male predominance, an average age of 7.8 years, and frequent occurrence in the head and neck (38.2%). Histopathologically, only 3.2% of NHL was nodular type and 96.8% was diffuse type (lymphoblastic 28.4%, histiocytic 19.5%, medium-size cell 18.6%, Burkitt's 14.6%, and miscellaneous 15.8%.) The characteristics of the 63 cases of HL were a male predominance, an average age of 9.3 years, 73% of primary lesions in the cervical nodes, and 46.6% of mixed cellularity type. The survival rate at 7 years estimated by the Kaplan -Meier method was 41.1% for patients with NHL, and 84.9% for patients with HL. Leukemic conversion and CNS involvement occurred in 27.9% and 22.9% of patients with NHL, respectively. The current multi-institutional treatment study for NHL conducted by the Children's Cancer and Leukemia Study Group (CCLSG) has improved the prognosis of childhood NHL to an 84.6% induction rate with initial therapy and a relapse-free survival rate of 55.6% at four years. The most important principle for the management of childhood malignant lymphoma is the recognition of the systemic nature of the disease.     

山东地区520 例淋巴瘤临床病理特点分析

目的：分析山东省地区近3 年淋巴瘤患者的病理类型及临床特点。方法：回顾性分析山东省肿瘤医院及山东省医学科学院附属医院2011年9 月至2014年9 月收治的520 例淋巴瘤患者资料,从性别、发病年龄、病理类型、发病部位等方面进行总结分析。结果：520 例淋巴瘤患者中,男女比例为1. 2 ：1,中位年龄51岁,霍奇金淋巴瘤（HL）67例占12.9% ,非霍奇金淋巴（NHL ）453 例占87.1% 。NHL 中75.9% 为B 细胞淋巴瘤,24.1% 为T/NK细胞淋巴瘤。HL以经典型霍奇金淋巴瘤结节硬化型为主,占52.2% ,年龄分布未见双峰性。NHL 最常见类型为弥漫大B 细胞淋巴瘤（DLBCL ）占54.1% ,其构成比高于其他国家和地区（18% ～42.7%）,男女比例为0. 9：1,发病年龄略早（中位年龄54岁）。 HL和NHL 发病部位均以颈部淋巴结多见,且NHL 结外起病多于结内起病。结论：520 例淋巴瘤以DLBCL 最常见,多数亚型以男性发病比例较高,但DLBCL 以女性发病率较高。结外淋巴瘤以鼻腔及胃肠道多见。     

Body mass index and risk of non-Hodgkin's and Hodgkin's lymphoma: a meta-analysis of prospective studies

We conducted a meta-analysis of prospective studies to summarise the epidemiologic evidence regarding the association of body mass index (BMI) with non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL) incidence and NHL mortality. Pertinent studies were identified by searching PubMed (1966-May 2011) and the reference lists of retrieved articles. For each study, we estimated a relative risk (RR) for a 5 kg/m(2) increase in BMI. A random-effects model was used to combine the RR estimates from individual studies. The summary RRs for a 5 kg/m(2) increase in BMI were 1.07 (95% confidence intervals (CI), 1.04-1.10) for NHL incidence (16 studies, n=17,291 cases) and 1.14 (95% CI, 1.04-1.26) for NHL mortality (five studies, n=3407 cases). BMI was significantly positively associated with risk of diffuse large B-cell lymphoma (RR, 1.13; 95% CI, 1.02-1.26), but not other NHL subtypes. The difference in risk estimates for subtypes was not statistically significant (P=0.10). There was evidence of a nonlinear association between BMI and HL (P for nonlinearity=0.01) (five studies, n=1557 cases). The summary RRs of HL were 0.97 (95% CI, 0.85-1.12) for overweight and 1.41 (95% CI, 1.14-1.75) for obesity. These results indicate that BMI is positively associated with risk of NHL and HL as well as with NHL mortality.     

Contribution of flow cytometry to the diagnosis of malignant and non malignant conditions in lymph node biopsies

In order to assess the contribution of FC to the diagnosis of lymph node disorders we retrospectively compared the pathological and the FC diagnosis made in 118 consecutive lymph node biopsies. Pathological diagnosis included non malignant conditions (n = 43), B-cell Non Hodgkin lymphoma (NHL) (n = 30), T-cell NHL (1 case), carcinoma (n = 18), Hodgkin lymphoma (HL) (n = 15), melanoma (n = 2), chronic myelocytic leukemia (n = 12), miscellaneous non-lymphoid tissues (n = 6) and undetermined conditions (n = 2). Among the 116 assessable samples, FC was in agreement with histology in 102 cases (87.9%; 95%CI = 81-93) which included 38 benign conditions (90%; 95% CI = 77-97%), 29 NHL (96.7%; 95% CI = 83-100), 18 carcinomas (100%; 95% CI = 81-100), and 12 HL (80.0%; 95% CI = 52-96). Discrepancies (14 cases) included 3 HL undiagnosed by FC and 2 granulomatous adenitis with an erroneous FC diagnosis of HL. Finally, a malignant condition was suspected only by FC in 5 cases (1 carcinoma, 2 B-cell and 2 T-cell NHL) and subsequently demonstrated by additional diagnostic procedures. In conclusion, this study confirms that FC performed on fresh lymph node samples is a powerful diagnostic tool in patients with malignant lymphoma. A few cases left undiagnosed by classical pathological analysis can be recognized by FC. Carcinoma is readily identified by FC analysis, while some benign conditions and Hodgkin lymphoma can be misdiagnosed with the use of FC, although the potential of FC to properly recognize HL is improving compared to previously reported studies. FC is a useful adjunct to pathological analysis of lymph node specimens.     

Do childhood diseases affect NHL and HL risk? A case-control study from northern and southern Italy

To investigate the association between non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), and exposure to childhood diseases, we analyzed an Italian case-control study that included 225 histologically-confirmed incident cases of NHL, 62 HL cases, and 504 controls. After adjusting for confounding factors, all examined childhood diseases were negatively associated with HL. Measles was negatively associated with NHL, particularly follicular B-cell NHL. Our findings provide additional support to the hypothesis that infections by most common childhood pathogens may protect against HL or, at least, be correlated with some other early exposure, which may lower the risk of HL in adulthood. In addition, our study shows that measles may provide a protective effect against NHL.     

Maternal smoking during pregnancy and childhood lymphoma: a meta-analysis

Results from epidemiological studies exploring the association between childhood lymphoma and maternal smoking during pregnancy have been contradictory. This meta-analysis included all published cohort (n = 2) and case-control (n = 10) articles; among the latter, the data of the Greek Nationwide Registry for Childhood Hematological Malignancies study were updated to include all recently available cases (-2008). Odds ratios (ORs), relative risks and hazard ratios were appropriately pooled in three separate analyses concerning non-Hodgkin lymphoma (NHL, n = 1,072 cases), Hodgkin lymphoma (HL, n = 538 cases) and any lymphoma (n = 1,591 cases), according to data availability in the included studies. An additional metaregression analysis was conducted to explore dose-response relationships. A statistically significant association between maternal smoking (any vs. no) during pregnancy and risk for childhood NHL was observed (OR = 1.22, 95% confidence interval, CI: 1.03-1.45, fixed effects model), whereas the risk for childhood HL was not statistically significant (OR = 0.90, 95% CI: 0.66-1.21, fixed effects model). The analysis on any lymphoma did not reach statistical significance (OR = 1.10, 95% CI = 0.96-1.27, fixed effects model), possibly because of the case-mix of NHL to HL. No dose-response association was revealed in the metaregression analysis. In conclusion, this meta-analysis points to a modest increase in the risk for childhood NHL, but not HL, among children born by mothers smoking during pregnancy. Further investigation of dose-response phenomena in the NHL association, however, warrants accumulation of additional data.     

恶性淋巴瘤受累淋巴结的全身螺旋计算机层析成像表现

目的探讨恶性淋巴瘤累及淋巴结的全身螺旋计算机层析成像（CT）表现及其解剖分布。方法回顾性分析89例诊治的淋巴瘤患者,其中霍奇金淋巴瘤（HL）12例,非霍奇金淋巴瘤（NHL）77例。所有患者均行颈部、胸部及全腹部CT直接增强扫描,记录所有病例肿大淋巴结分布、大小、密度及强化程度。结果HL组患者中普遍均匀强化9例（75．0％）,均匀强化伴坏死3例（25．0％）;NHL组中普遍均匀强化64例（83．1％）,均匀强化伴坏死13例（16．9％）,两组均匀强化情况比较差异无统计学意义（Fisher精确概率法,P=0．4461）。HL组中淋巴结呈融合状6例（50．0％）,不融合6例（50．0％）;NHL组中淋巴结呈融合状8例（10．4％）,不融合69例（89．6％）,两组比较差异有统计学意义（Fisher精确概率法,P=0．0028）。HL组患者常优势累及颈部及纵隔淋巴结,NHL组患者常优势累及颈部、纵隔及腹腔淋巴结,两组全身淋巴结累及优势分布差异无统计学意义（Fisher精确概率法,P=0．110）。结论全身螺旋CT扫描能很好的显示淋巴瘤患者全身淋巴结肿大的形态、部位及分布。     

Consanguinity and family history of cancer in children with leukemia and lymphomas.

BACKGROUND: In native population of the United Arab Emirates (UAE), the rate of consanguineous marriages is 50.5%. This study was designed to determine whether the rates of consanguinity and family history of cancer among the families of children with lymphoid malignancy are different from those in the general population. METHODS: The study comprised 117 patients from the whole of the country with acute lymphocytic leukemia (ALL) and Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), ranging in age from 2 to 14 years. The consanguinity rate in the study group was compared with the rate in the general population. To study family history of cancer, the authors matched patients with 117 controls. In a telephone interview, each mother was asked to provide data regarding the biologic relationship between her and her husband as well as that between both sets of grandparents; each was also asked whether any family relative had a cancer and, if so, of what type. RESULTS: Among the 69 ALL cases, 80% of families were consanguineous and 20% were nonconsanguineous. Among the 26 NHL and 22 HL cases, each group included 3 consanguineous families, 12% and 14%, respectively. The consanguinity rates for ALL, NHL, and HL were all significantly different from the 50.5% consanguinity rate in the UAE population (all three P values < 0.0001). The family history of cancer was more often positive in ALL patients than in controls (odds ratio, 2.14; confidence interval, 1.01--4.53). Overall and for each lymphoid malignancy, there was no difference in family history of cancer between consanguineous and nonconsanguineous groups of cases. CONCLUSIONS: The consanguinity rate in the families of patients with ALL is significantly higher and in those with NHL and HL significantly lower than that in the UAE population. The family history of cancer is more often positive among ALL cases than controls--consanguinity having no effect.     

No association between the TP53 codon 72 polymorphism and risk or prognosis of Hodgkin and non-Hodgkin lymphoma

The role of the TP53 gene's R72P polymorphism in non-Hodgkin lymphoma (NHL) has been analyzed in several studies but it has not been studied in Hodgkin lymphoma (HL). We have evaluated the role of R72P in 340 NHL and 298 HL patients. There was no difference in the R72P frequency between analyzed lymphoma cases and 749 controls. We found no association of R72P with the risk of NHL and HL development [OR_{ArgPro/ProPro} = 0.9 (95% CI 0.7-1.2) and 1.2 (95% CI 0.9-1.5), respectively] or with survival. Our results support the evidence that R72P is not a prognostic factor in Caucasian NHL patients, and they indicate its irrelevance for HL development or prognosis.