腰椎管内非霍奇金淋巴瘤1例报道

在我国,非霍奇金淋巴瘤约占淋巴瘤的85％.非霍奇金淋巴瘤起源于淋巴结或淋巴组织,可侵犯结外组织.原发于结外的非霍奇金淋巴瘤较多见于中枢神经系统、胃肠道和睾丸.而原发于中枢神经系统的非霍奇金淋巴瘤多发生于颅内,累及椎管硬膜外者极少见.现将本院收治的1例腰椎管内非霍奇金淋巴瘤报告如下.     

原发胃肠道非霍奇金淋巴瘤治疗进展

 胃肠道是原发结外非霍奇金淋巴瘤（NHL）最常见的侵犯部位。与原发结内的NHL相比,原发胃肠道非霍奇金淋巴瘤（PGI-NHL）的治疗有很大的特殊性。目前对于弥漫型病变首选联合化疗,手术仅被用于病变的局部控制预防和治疗局部并发症,放射治疗被用于残留病变的清除及严重的局部病变。对于幽门螺杆菌阳性的患者,均应进行抗幽门螺杆菌的治疗。针对PGI-NHL的治疗方法及进展进行综述。     

骨原发非霍奇金淋巴瘤——附20例临床报告

骨原发非霍奇金淋巴瘤是指起源于骨髓腔的淋巴瘤,同时不伴区域淋巴结或内脏受累者[1].由于其发病率低,故诊断标准、治疗模式等仍在探索中[2].本文总结我院1984年12月至1998年12月骨原发非霍奇金淋巴瘤的临床资料,分析其临床分期和治疗方法与预后的关系.     

原发性结外非霍奇金淋巴瘤127例临床特征及误诊分析

目的分析淋巴结外非霍奇金淋巴瘤(NHL)的临床表现特点及误诊原因。方法回顾性分析127例原发结外非霍奇金淋巴瘤的发病情况、原发部位分布情况、首发症状及误诊情况等。结果原发于结外的非霍奇金淋巴瘤12／例，占同期非霍奇金淋巴瘤53．81％(127／236)；原发部位前5位依次为：胃肠道21．26％(27／127)，鼻腔18．9％(24／127)，Waldeyer环14．96％(19／127)，脾脏12．6％(16／127)，皮肤6．3％(8／127)；结外奇非霍金淋巴瘤误诊率为69．29％(88／127)；结外非霍奇金淋巴瘤首发症状因原发部位不同而临床表现各异，无特异性。结论结外NHL发生率较高，其临床表现缺乏特异性，早期易误诊。     

原发肠道恶性淋巴瘤诊断和治疗的新观点

原发胃肠道恶性淋巴瘤（primary gastrointestinal lymphoma，PGIL）是最常见的结外淋巴瘤，占非霍奇金淋巴瘤（non-Hodgkin lymphoma，NHL）的12％，占所有结外原发淋巴瘤的30％～40％．原发肠道恶性淋巴瘤（primary intestinal lyrephoma，PIL）占PGIL的20％～30％与所有结外NHL的5％。近年来PIL发病率有所增加。     

原发乳腺非霍奇金淋巴瘤6例临床分析

目的 分析原发乳腺非霍奇金淋巴瘤的临床特点,探讨诊断、分期和治疗方法及其预后的影响因素。方法 回顾性分析6例原发乳腺非霍奇金淋巴瘤的临床资料。6例病例均获随访,均于手术局部切除后辅助化疗和（或）放疗。结果 6例的中位生存期为53．5个月,均无瘤生存。结论 与原发乳腺非霍奇金淋巴瘤预后密切相关的因素依次是临床分期、病理类型和原发肿瘤大小、对原发乳腺非霍奇金淋巴瘤行综合治疗,可取得满意疗效。     

腹型恶性淋巴瘤20例临床报告

腹型淋巴瘤系指主要原发于胃肠道及胃肠道外的腹腔原发恶性淋巴瘤。本组腹型淋巴瘤20例,其临床以腹痛、腹胀、腹块、体重减轻及腹泻、便血等为主要特点。腹型淋巴瘤以非何杰金淋巴瘤(NHC)为多,其组织学则以弥漫型B细胞为主。胃肠道是结外淋巴瘤的好发部位之一。本组病例腹部肿瘤明显,仅3例同时存在腹外病灶。腹型淋巴瘤应用包括外科手术、放疗、化疗等的综合治疗,胃肠道原发淋巴瘤如有机会获得根治手术切除则预后较好,同时亦提示加强化疗强度及加强治疗后随诊的必要性。     

胃肠道淋巴瘤的研究进展

 胃肠道淋巴瘤（PGIL）是最常见的结外淋巴瘤,文章综述了其病理、临床特征、治疗方法和预后。PGIL与结内淋巴瘤及胃肠道癌不同,治疗包括手术、放化疗等综合治疗及生物治疗;预后与多种因素如病理分型、免疫表型、国际预后指数（IPI）、原发部位、肿瘤大小及分期相关。     

胃肠道弥漫大B细胞淋巴瘤的治疗及相关潜在预后因素的研究进展

弥漫大B细胞淋巴瘤（diffuse large B-cell lymphoma，DLBCL）是非霍奇金淋巴瘤（non-Hodgkin's lymphoma，NHL）中最常见类型，是成年人发病率较高的中高度恶性淋巴瘤，在临床表现上多为侵袭性病程，多表现为无痛性进行性肿大的淋巴结，但也可表现为原发于结外，其中胃肠道是DLBCL最好发的结外部位，虽然关于DLBCL的治疗已渐规范化，但由于胃肠道DLBCL起病隐匿，临床症状不典型，其治疗尚无统一的标准，且影响其生存的预后因素较多，因此为提高临床对此疾病的认识，以便因人而异的制定治疗方案及评估其生存预后，现对其治疗方式的选择及影响预后的相关因素的最新进展进行综述。     

胃肠道弥漫大B细胞淋巴瘤的治疗及相关潜在预后因素的研究进展

弥漫大B细胞淋巴瘤（diffuse large B-cell lymphoma，DLBCL）是非霍奇金淋巴瘤（non-Hodgkin's lymphoma，NHL）中最常见类型，是成年人发病率较高的中高度恶性淋巴瘤，在临床表现上多为侵袭性病程，多表现为无痛性进行性肿大的淋巴结，但也可表现为原发于结外，其中胃肠道是DLBCL最好发的结外部位，虽然关于DLBCL的治疗已渐规范化，但由于胃肠道DLBCL起病隐匿，临床症状不典型，其治疗尚无统一的标准，且影响其生存的预后因素较多，因此为提高临床对此疾病的认识，以便因人而异的制定治疗方案及评估其生存预后，现对其治疗方式的选择及影响预后的相关因素的最新进展进行综述。     

Primary gastrointestinal non-Hodgkin's lymphoma in a population-based registry

In a population-based registry of 580 patients with non-Hodgkin's lymphoma (NHL) 54 patients had a primary gastric lymphoma, 42 an intestinal, 113 a primary extranodal lymphoma localised elsewhere than in the gastrointestinal tract and 371 a primary nodal NHL. Histological specimens were reviewed by a panel of pathologists and classified according to the Kiel classification and the International Working Formulation. The 4-year survival rates for primary gastric, intestinal, other extranodal and nodal NHL ranged from 50 to 60%; the 4-year recurrence-free survival rates were 50%, 35%, 19% and 19%, respectively. Among patients with localised intermediate-grade disease survival for those with gastric NHL was better than for those with intestinal lymphoma. Because it is population-based, our study cohort was not subjected to exclusion due to age, performance scale, etc. and therefore provides a more realistic picture of the occurrence and presentation of as well as prognosis for lymphoma in the population.     

Descriptive epidemiology of gastrointestinal non-Hodgkin's lymphoma in a population-based registry

The incidence of non-Hodgkin's lymphoma (NHL), particularly at certain extranodal sites, has been demonstrated to be rising, at least in the USA, more than for any other malignancy. One of the major sites of extranodal NHL is the gastrointestinal tract, though little is known of its epidemiological characteristics. Over an 8-year period (1986 to 1993) 1069 primary gastrointestinal NHL cases were reported to the Leukaemia Research Fund Data Collection Survey which covers many parts of England and Wales. Age-standardized incidence rates of gastrointestinal NHL at all sites (0.58/10(5) per year), gastric (0.24/10(5) per year), small bowel (0.17/10(5) per year) and large bowel (0.06/1(5) per year) confirmed that the UK has the lowest rates of gastrointestinal NHL in Europe. An excess of males was observed at all ages and for all sites. Time-trend analyses showed annual increases in incidence rates for gastric (6.3%) and small bowel (5.9%) NHL although a concomitant decrease in gastrointestinal NHL of unknown site suggested that at least part of these increases had resulted from more accurate diagnoses. Overall, the incidence of gastrointestinal NHL significantly increased by 2.7% per annum and was limited to the population aged over 50 years in this series.     

Clinical prognostic analysis of 116 patients with primary intestinal non-Hodgkin lymphoma

The gastrointestinal tract is the most common extranodal invasion site of non-Hodgkin lymphoma (NHL). Primary gastrointestinal NHL is often discussed together in most survival analyses. Primary intestinal NHL is significantly different from primary gastric NHL with regard to clinical features, pathological subtype, treatment, and prognosis. In this article, we analyzed clinical and pathological characteristics of primary intestinal NHL, and we also explored prognostic factors for primary intestinal NHL. A retrospective analysis was carried out on clinical data from 116 cases of confirmed primary intestinal NHL. The Kaplan–Meier method was used for the survival analysis. A Cox model was used for a multivariate analysis. In 116 patients with primary intestinal NHL, 79 patients were men (68.1%) and 37 patients were women (31.9%). In the cases used in this study, 68 were B-cell NHL and 48 were T-cell NHL. The age, incidence of intestinal obstruction, B symptom and performance status (PS) were closely related with pathological subtype. One-year and two-year survival rates were 76.7 and 58.3%, respectively. The log-rank univariate analysis showed male patients, PS score greater than or equal to two, hypoproteinemia, intestinal perforation, T-cell type, late stage (III/IV), no radical surgery, and no chemotherapy had relatively poor prognoses. Cox multivariate analysis shown that gender (95.0% CI 0.218–0.721), pathological subtype (95.0% CI 1.484–4.179), and radical surgery (95.0% CI 0.110–0.394) were independent prognostic risk factor for primary intestinal NHL. Male patients, T-cell intestinal lymphoma, and no radical surgery had rapid clinical processes and poor prognoses.     

Clinicopathologic features and prognostic factors of primary extranodal non-Hodgkin's lymphomas in Turkey

Clinical, histopathologic, and prognostic features of 114 patients with primary extranodal non-Hodgkin's lymphoma were evaluated. Median age of the patients was 48 (range, 15-76) and the ratio of male/female was 55/59. Thirty-seven patients had stage 1, 55 patients stage II, 6 patients stage III, and 16 patients stage IV. The most common sites of primary extranodal non-Hodgkin's lymphoma were the gastrointestinal (GI) tract and head-neck region. Stomach (66%) and tonsils (33%) were the most frequently involved organ in GI tract and head-neck region, respectively. Eighty percent of patients had intermediate or high-grade lymphomas, 20% had low-grade subtypes. Complete remission was achieved in 83% of all patients with chemotherapy +/- radiotherapy +/- surgery. Overall and disease-free survival at 5 years were 63% and 59%, respectively. In conclusion, clinical and histopathologic characteristics and prognosis of our cases with primary extranodal non-Hodgkin's lymphoma were usually similar to those of the cases in Western countries with some differences in the incidence of some specific primary extranodal non-Hodgkin's lymphomas and in the histopathologic subtypes.     

Localised extranodal non-Hodgkin's lymphoma of the gastrointestinal tract: Sheffield Lymphoma Group experience (1989-1998)

Extranodal non-Hodgkin's lymphoma (NHL) of the gastrointestinal tract accounts for about one third of all extranodal NHL. We retrospectively reviewed the clinical and histopathologic records of 71 patients with stage IE and IIE primary gastrointestinal NHL referred to the Sheffield Lymphoma Group (SLG) from 1989 to 1998. Cross-referencing with the Hospital Histopathology Department database revealed that only two-thirds of all cases were seen by the Group. The most common primary site was the stomach (45 patients, 63% of all cases), followed by the small intestine (16, 23%) and large intestine (9, 13%). The median age of patients was 62 years; the majority of patients presented with stage I (61%) and/or grade (65%) NHL. Mucosa-associated lymphoid tissue (MALT) lymphomas were the largest histologic subtype seen (57%), with 87% of these arising from the stomach; next most frequent was the diffuse large B-cell subtype (21% of all cases) most frequently arising from the intestine (60%). For treatment of gastric MALT lymphoma, a combined approach (surgery followed by chemotherapy, antihelicobacter therapy followed by chemotherapy) was favoured (22 cases). Five-year and 10-year overall survivals were 52% and 45% respectively. Knowledge of the Revised European American Lymphoma classification and the Helicobacter pylori/MALT association has influenced treatment approaches over the 10-year study period. For small intestinal lymphoma, surgery (with or without chemotherapy) gave 5- and 10-year survivals of 60%. Overall survival of patients with primary gastrointestinal lymphoma managed by the SLG is similar to that reported from other large series.     

Clinical staging of adult non-Hodgkin's lymphoma

In this study an attempt is made to propose a working clinical classification and staging of adult non-Hodgkin's lymphoma (NHL) which brings out both primary site and extent of disease. Unlike childhood NHL, where histopathology is uniformly of unfavourable type, this clinical staging system seems to have a prognostic value when applied with reference to different histology groups of working formulation. Based on the experience of staging of childhood NHL as proposed earlier, 304 cases of adult NHL above 14 years of age seen at Kidwai Memorial Institute of Oncology, Bangalore, India, over a period of 5 years (1981-1985) are first categorized according to primary site (initial bulky site at presentation): (1) peripheral nodal (n = 181; (2) extranodal (excluding gastrointestinal tract; n = 48); (3) abdominal (including gastrointestinal tract; n = 46), and (4) mediastinal (n = 29). Each group is further staged according to the extent of the disease. Once categorized into various clinical groups, the Ann Arbor Clinical staging fits very well only with the peripheral nodal group, the major group, although not suitable for other clinical groups.     

原发性淋巴结外淋巴瘤54例临床分析

目的 探讨原发性淋巴结外淋巴瘤的临床特点、诊断、治疗及预后。方法 自1980年1月至2001年12月，对所收治非霍奇金淋巴瘤105例患进行回顾性分析。结果 确诊为结外淋巴瘤54例(51．4％)。54例中发生于消化道最多，共19例(35．2％)，其次为鼻及咽部组织，共16例(29．6％)，其他部位少见共19例(35．2％)。治疗以手术，放疗及化疗为主。结论 结外淋巴瘤发生于消化道，鼻咽部组织为多，但可发生于任何器官组织，其临床表现无特异性，诊断困难，易发生误诊误治。针对发病升高趋势，临床医师应具有多学科横向知识，加强对结外淋巴瘤的认识，早期诊断，综合治疗改善预后。