骨原发性淋巴瘤继发中枢神经系统浸润1例病例报告及文献复习

目的:探讨骨原发性淋巴瘤(primary bone lymphoma,PBL)继发中枢神经系统(CNS)浸润的主要临床特点、诊断及治疗。方法:分析我科收治的1例弥漫大B细胞性PBL继发CNS浸润患者的临床表现及相关检查结果,治疗方法,并复习相关文献。结果:本例患者为老年男性,主要临床表现为骨痛,经PET/CT、骨髓象、骨组织活检、免疫组化及流式细胞学等检查确诊为弥漫大B细胞性PBL。行R-CHOP化疗方案治疗,化疗后症状缓解,但出现CNS浸润。先后给予6次鞘内注射(Ara-C、MTX、DEX),并同时2次大剂量的甲氨蝶呤(HD-MTX)系统性化疗,10次腰骶部放疗后,症状缓解,但3个月后因肺部感染死亡。结论:本例患者以骨痛为首发表现,PET/CT结合MRI示多发骨损害,经骨髓象及活检、免疫组化染色,流式细胞学检查明确诊断,对PBL应重视CNS侵犯及预防。     

原发性心脏淋巴瘤一例并文献复习

原发性心脏淋巴瘤临床较罕见,通常定义为仅累及心脏或(和)心包的非霍奇金淋巴瘤。由于本病临床表现的非特异性,诊断较为困难,而且预后相对较差。本文所介绍的患者在切除心脏内肿瘤并诊断为弥漫大B细胞淋巴瘤后,最终经过6个周期的R-CHOP方案的化疗达到完全缓解。     

原发性骨淋巴瘤l例

患者女 ,5 8岁。因右上臂疼痛 2个月 ,活动受限 1个月 ,于 2 0 0 2年 1 2月 1 1日入我院骨外科。患者 2个月前无明显诱因出现右上臂钝痛 ,局部无红肿 ,曾于院外服用止痛药物 ,疼痛略有缓解。入院前 1个月晨起发现右上肢活动受限 ,在外院拍片示右肱骨骨折 ,用小夹板外固定并对症处理 (具体不详 ) ,疼痛仍明显 ,遂来我院就诊 ,以“右肱骨骨折”收入骨外科。患者自发病以来无明显咽痛、鼻塞 ,无腹痛、腹泻、食欲减退 ,无发热、盗汗、消瘦、皮肤瘙痒 ,未发现体表肿物。体检 :体温 36.8℃ ,脉搏 80次/min ,呼吸 1 9次 /min ,血压 1 60 /1 1 0mmH…     

原发性中枢神经系统恶性淋巴瘤4例

原发性中枢神经系统恶性淋巴瘤４例沈阳军区总医院刘彦琴，王海林辽阳辽化职工医院富江，余文海原发性中枢神经系统恶性淋巴瘤少见，国外报道占恶性淋巴瘤的２％，脑部肿瘤的０．０１％，近几年来我们遇到的４例，报告如下：１病例介绍（见附表）附表４例原发性中枢神经系...     

原发性肝脏T细胞淋巴瘤1例报告并文献复习

原发性肝脏淋巴瘤(primary hepatic lymphoma,PHL)是一种源自肝内淋巴组织的少见恶性肿瘤,迄今报道均为非霍奇金淋巴瘤,国内外文献报道仅100余例,约占结外淋巴瘤的0.14％,占肝脏恶性肿瘤的0.11％[1].国外报道部分PHL患者可合并自身免疫性疾病、慢性肝炎、原发性胆汁性肝硬化、乙型肝炎病毒(hepatitis B virus,HBV)和丙型肝炎病毒(hepatitis C virus,HCV)感染以及获得性免疫缺乏综合征(acquired immune deficiencysyndrome,AIDS)等[2].     

原发性骨淋巴瘤的临床诊疗进展

原发性骨淋巴瘤(primary bone lymphoma,PBL)是一种十分罕见的疾病,是指病变仅限于骨骼系统或周围软组织浸润而没有其他骨外病变的淋巴瘤。Oberling在1928年首次发现了PBL,1939年Parker和Jackson研究了当时17例     

脾原发性恶性淋巴瘤4例报告

脾原发性恶性淋巴瘤４例报告顾超江苏省太仓市第一人民医院（２１５４００）脾原发性恶性淋巴瘤罕见，国内资料不多。我院１９７６年至１９９６年，经手术和病理证实为脾原发性恶性淋巴瘤４例，现结合文献报道如下。１资料与结果男３例，女１例，年龄５５～６７岁，平均６...     

原发性心脏淋巴瘤1例及文献复习

正病历资料:患者女性,46岁,因间断发作右侧肩背部不适伴乏力2月余入院。病史:2个月前无明显诱因出现前胸部及肩背部不适,自述为烧灼感,伴乏力、无胸闷、无胸痛、夜间不能平卧,于当地医院检查提示右心房、心包腔内实质性占位病变,伴中量心包积液,入院就诊。既往高血压15年,糖尿病病史15年,无传染病史,无饮酒吸烟史,无免疫缺陷疾病等相关病史,2年前行踝关节滑膜软骨瘤切除术及肾     

原发性胰腺淋巴瘤1例报告并文献复习

原发性胰腺淋巴瘤（primary panereas lymphoma,PPL）是一种罕见的恶性肿瘤，占结外恶性淋巴瘤的2％以下，占胰腺肿瘤的0．5％以下。国内有关PPL的报道较少见，且多为个案报道，对其认识尚不足，较少引起临床医生的重视。我们收治了1例PPL患者，结合国内外文献进行总结分析，以提高对PPL的诊治认识。     

12例原发性骨淋巴瘤患者的临床特点及预后分析

目的:探讨原发性骨淋巴瘤(PBL)的临床特征及其对预后的影响。方法:对2014年12月—2019年12月收治的12例PBL患者资料进行回顾性分析,探讨其临床特征及预后影响因素。结果:12例患者病理类型均为弥漫大B细胞淋巴瘤,其中男5例,女7例;中位年龄59岁;主要发病部位为股骨(4例)和脊柱(3例);6例行放化疗联合治疗,6例行单纯化疗;全组患者中位随访时间为38.4个月,中位无进展生存时间为14.4(95%CI 9.5～19.3)个月,中位总生存时间为22.1(95%CI 11.1～33.1)个月。单因素分析结果显示,美国东部肿瘤研究组(ECOG)评分、有无软组织侵犯、初始治疗是否达完全缓解与总生存时间有关,β2微球蛋白水平、有无软组织侵犯与无进展生存时间有关(P<0.05)。而国际淋巴瘤预后指数(IPI)评分无论对于总生存时间还是无进展生存时间均差异无统计学意义。多因素分析结果提示,β2微球蛋白水平是影响患者无进展生存时间的独立预后因素(P<0.05)。结论:IPI对PBL患者预后的影响仍需进一步讨论,β2微球蛋白处于正常水平的PBL患者预后较好。可考虑根据β2微球蛋白...     

Primary follicular lymphoma of the cervix uteri: a review

Primary non-Hodgkin’s lymphoma of the cervix is a rare disease, of which a subgroup of follicular lymphoma constitutes only 8.5%. There is not an established treatment protocol neither for primary cervical lymphoma nor for its follicular subgroup. We presented a case with Ann Arbor stage IEA (Extra-nodal involvement and absence of weight loss, fever, night sweat) primary follicular lymphoma of the cervix. She was treated with chemotherapy followed by pelvic radiotherapy. Upon relapse with a nodal neck mass, she was treated with rituximab alone. She remained well for 23 months after rituximab. In the 39 months of follow-up, there was no evidence of disease. In the light of our case, we reviewed the reported cases of primary follicular lymphoma of the cervix while discussing their treatment protocols and the cases of primary cervix lymphoma treated with rituximab.     

Primary hepatic diffuse large B cell lymphoma: A case report: Primary hepatic diffuse large B cell lymphoma

In this report we describe a rare case of primary hepatic diffuse large B cell lymphoma in a 67-year-old man who presented with abdominal pain, deteriorated liver function, elevated lactate dehydrogenase. He was found to have diffuse nodular intrahepatic space-occupying lesion with normal α-fetoprotein and carcino-embryogenic antigen. The final diagnosis was made by percutaneous biopsy of the liver as the clinical manifestation not consistent with common liver diseases. The patient was treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) without surgical resection with a favorable response. However, serious complication was occurred after 4 cycles of chemotherapy, and the patient finally died of concurrent acute respiratory distress syndrome.     

Primary non-Hodgkin's lymphoma of the vagina case report and review of the literature

The genital tract as primary site of malignant non-Hodgkin's lymphoma in women is extremely rare, whereas secondary involvement in advanced disease is found in about 40% of cases. In this report a patient is presented who had a primary vaginal non-Hodgkin's lymphoma of the centroblastic type according to the Kiel classification, with an excellent response to cytotoxic chemotherapy (CHOP) and event-free disease for 3 years. A review of the literature shows that favorable prognosis of localized disease seems to be a common experience. Primary involvement of the vagina can be successfully treated by pelvic irradiation, but in young women cytotoxic chemotherapy should be considered to preserve fertility.     

异基因造血干细胞移植后继发T细胞淋巴瘤的研究(附1例报告)

目的：研究干细胞移植后T细胞淋巴瘤及发病机制。方法：回顾性分析1例干细胞移植后T细胞淋巴瘤患者的临床资料。结果：干细胞和一T细胞淋巴瘤与干细胞移植后B细胞淋巴瘤，及实体器官移植后T细胞淋巴瘤比较有如下特点：发病年龄小，GVHD明显，肿瘤细胞多为供者来源，多为多克隆性，与EBV无关等。结论：干细胞移植后T细胞淋巴瘤倾向为一独立疾病。     

Primary lymphoblastic B-cell lymphoma of the stomach： A case report

Primary stomach lymphoblastic B-cell lymphoma （B-LBL） is a rare tumor. We describe a primary stomach B-LBL in a 38 years old female who presented with nonspecific complaints of fatigue and vomiting for 2 mo. Gastrofiberscopy revealed a large gastric ulcer, which was successfully resected. Pathology showed a lymphoblastic cell lymphoma arising from the stomach, and there was no evidence of disease at any extrastomach site. Immunohistochemical staining and gene rearrangement studies supported that the stomach tumor was a clonal B-cell lymphoma. Therefore, the diagnosis of B-LBL was made based on the stomach specimen.     

Primary pancreatic lymphoma： Report of six cases

AIM: To heighten recognition of primary pancreatic lym phoma (PPL) in clinical practice. METHODS: A retrospective review of the clinical presentation, imaging characteristics and pathological features of PPL patients were presented, as well as their diagnosis and treatment, in combination with literature review. RESULTS: Histological diagnosis was made in four patients by surgery and in two patients by EUS-FNA. The six PPL patients (5 males and 1 female; age range, 16-65 years; mean age, 46 years) had the duration of symptoms for two weeks to three months. The primary presenting symptoms, though not characteristic, were abdominal pain, abdominal masses, weight loss, jaundice, nausea and vomiting. One of the patients developed acute pancreatitis. In one patient, the level of serum CA19-9 was 76.3μg/L. Abdominal CT scan showed that three of the six tumors were located in the head of pancreas, two in the body and tail, and one throughout the pancreas. Diameter of the tumors in the pancreas in four cases was more than 6 cm, with homogeneous density and unclear borders. Enhanced CT scan showed that only the tumor edges were slightly enhanced. The pancreatic duct was irregularly narrowed in two cases whose tumors were located in the pancreatic head and body, in which endoscopic retrograde cholangiopancreatography (ERCP) showed that the proximal segment was slightly dilated. Two patients underwent Whipple operation, one patient underwent pancreatectomy, and another patient underwent operative biliary decompression. PPL was in stage I E in 2 patients and in stage II E in 4 patients according to the Ann Arbor classification system. The diagnosis of B-cell non-Hodgkin's lymphoma was made in all patients histopathologically. All six patients underwent systemic chemotherapy, one of whom was also treated with gamma radiometry. One patient died two weeks after diagnosis, two patients lost follow-up, two patients who received chemotherapy survived 49 and 37 mo, and the remaining patient is still alive 21 mo, after diagnosis and treatment. CONCLUSION: PPL is a rare form of extranodal lympho-ma originating from the pancreatic parenchyma. Clinical and imaging findings are otherwise not specific in the differentiation of pancreatic lymphoma and pancreatic cancer, which deserves attention. EUS-guided fine-needle aspiration (EUS-FNA) of the pancreas requires experienced cytopathologists as well as advanced immunohis-tochemical assays to obtain a final diagnosis on a small amount of tissue. Surgery and adjuvant chemotherapy or radiotherapy can produce fairly good outcomes.     

原发骨淋巴瘤42例临床分析

目的探讨原发骨淋巴瘤(PBL)的临床特点及预后。方法入选西京医院2006年至2014年期间收治的PBL患者42例,男24例,女18例,中位年龄45.6(11~78)岁,收集患者的临床资料,包括性别、年龄、有无全身症状、发病部位、临床分期、病理类型、治疗方案、疗效评价等,进行回顾性分析,通过电话和门诊随访至2015年3月。结果 42例患者均以病变部位疼痛或牵涉性麻木为首发临床表现。病理分型均为非霍奇金淋巴瘤(NHL),50%(21/42)为弥漫大B细胞淋巴瘤(DLBCL)。其中17例患者接受了治疗,5例放化疗联合,12例单纯化疗,两组比较,近期疗效差异无统计学意义(P0.05)。4个疗程后评估近期疗效,年龄、性别、分期、乳酸脱氢酶(LDH)水平、有无全身症状、病理分型、美国东部肿瘤协作组(ECOG)评分、国际预后指数(IPI)评分、是否应用利妥昔单抗治疗、是否联合放疗等对完全缓解率(CR)的影响无统计学意义(P0.05)。中位随访时间13(2~48)个月,无进展生存期3年的4例患者中3例应用了利妥昔单抗。结论 42例PBL患者病理类型主要为DLBCL,治疗以化疗为主,联合放疗未明显提高疗效,应用利妥昔单抗可能会改善预后,尚需扩大样本量进行研究。