9例原发乳腺淋巴瘤临床分析并文献复习

目的 探讨原发乳腺淋巴瘤的临床病理学特征及综合治疗效果.方法 对2013年1月至2020年1月包头市肿瘤医院收治的9例原发乳腺淋巴瘤患者的临床特征、病理特征及综合治疗的疗效进行回顾性分析,并复习相关文献.结果 所有9例原发乳腺淋巴瘤患者均为女性,年龄23～69岁,中位年龄41岁,且均为非霍奇金淋巴瘤.6例为弥漫大B细胞...     

原发乳腺淋巴瘤14例临床分析并文献回顾

目的：探讨原发乳腺淋巴瘤（primary breast lymphoma,PBL）的治疗方法及预后。方法：对军事医学科学院附属医院淋巴瘤科2005-07-15-2011-01-20收治的14例PBL患者的临床特征、病理特点、治疗方法及预后进行回顾性分析。结果：14例PBL均为女性,中位年龄48岁;ⅠE及ⅡE期各7例;病理类型均为B细胞淋巴瘤。其中3例行患侧全乳切除并腋窝淋巴结清除术,9例行乳腺肿物切除术,2例行乳腺肿物核芯针穿刺活检术。10例接受化放疗,4例单纯化疗,4例同时行中枢预防性鞘内注射;其中一线化疗完全缓解率为86%。中位随访53.5个月,7例复发,3例死亡;5年无进展生存率为39%,5年总生存率为72%。结论：全乳切除未使PBL患者获益。乳腺肿物切除明确病理、以蒽环类为主的化疗联合受累野放疗可为适宜的选择。由于PBL中枢复发率较高,故建议中枢预防鞘内注射。     

原发乳腺淋巴瘤4例并文献复习

目的：探讨原发乳腺淋巴瘤（primary breast lymphoma,PBL）的临床病理学特征、免疫表型、鉴别诊断.方法：对4例原发乳腺淋巴瘤的临床资料、光镜形态和免疫表型进行回顾性分析,并复习文献.病理诊断依据WHO关于淋巴造血组织肿瘤的分类（2008版）进行.采用免疫组织化学EnVision两步法行免疫表型检测,选用的抗体有CD20、CD3ε、CD79a、PAX-5、CD10、Bcl-6、MUM-1、CD5、Bcl-2、p53、细胞周期蛋白D1和Ki-67等.结果：4例均为女性,年龄38-79岁.其中2例发生于左乳腺,1例发生于右乳,1例双侧乳腺均有肿物.患者均表现为孤立性无痛包块.Ann Arbor分期：1例为Ⅰ期,2例为Ⅱ期,1例为Ⅳ期.其中3例行乳腺肿块单纯切除术,1例行乳腺改良根治术.术后2例放弃治疗,1例行CHOP方案治疗,1例行R-CHOP方案治疗.4例术后病理诊断结果均为弥漫大B细胞淋巴瘤,根据Hans免疫组化亚群分类,其中1例为生发中心源性,3例为非生发中心源性.大体上,肿瘤呈灰白或灰红色结节状,直径2.5-5cm,质地韧或较脆.2例获得随访资料,1例随访12个月仍健在,1例已随访24个月仍在治疗之中,未发现复发及转移迹象.结论：该组4例PBL均为DLBCL.光镜及免疫组化检查可确定诊断.其诊断应充分排除系统性淋巴瘤累及乳腺.预后与肿瘤细胞免疫组化亚群及临床分期相关.     

原发乳腺淋巴瘤心脏复发一例并文献复习

目的 探讨原发乳腺淋巴瘤(PBL)复发后心脏累及患者的临床特点、生物学特征.方法 回顾性分析1例PBL患者复发后发生心脏累及的诊治经过,并复习相关文献.结果 该例PBL患者化疗缓解2年后心脏复发,再次缓解后1年第二次复发,再次诱导缓解后接受自体干细胞移植治疗,随访至截稿日未复发.结论 PBL心脏复发罕见,提示PBL可能有不同的生物学特征.     

双原发乳腺淋巴瘤11例临床分析

目的:探讨双原发乳腺淋巴瘤(bilateral primary breast lymphoma,BPBL)的临床病理特征、诊断、治疗和预后。方法:对本院收治的11例BPBL患者进行临床病理特征、治疗和预后的回顾性分析。结果:11例BPBL患者的年龄为13～63岁,中位年龄34岁;乳腺肿块生长迅速,直径最大者20cm;以双侧乳腺同时发病多见;B症状和血清乳酸脱氢酶水平升高者少见;腋下淋巴结转移和远处转移多见。BPBL病理类型以B细胞来源为主,病理分级以中～高度恶性为主。本组BPBL患者的中位生存期为33个月。化疗对BPBL至关重要。结论:BPBL临床误诊率较高,诊断时必须结合临床病理特征和影像学检查等手段,治疗方式以化疗为主。     

原发性乳腺淋巴瘤27例临床分析并文献复习

背景与目的:原发性乳腺淋巴瘤(primary breast lymphoma,PBL)发病率低,预后较差.本研究旨在分析该病例的临床和病理特征,从而探讨PBL的合理治疗模式.方法:收集并回顾性分析1976年到2005年间在中山大学肿瘤防治中心诊断为PBL,并接受治疗的27例患者的临床资料和治疗情况.结果:27例中有26例女性和1例男性患者;年龄12～84岁;90%的患者为Ⅰ E期或ⅡE期.按照WHO 2001淋巴瘤病理分类系统,有22例B细胞性淋巴瘤(17例弥漫大B细胞性淋巴瘤,2例黏膜相关性淋巴瘤,1例边缘区淋巴瘤,2例未能分类),3例外周T细胞性淋巴瘤,2例患者的病理类型未能分类.初始治疗时有20例患者接受了综合治疗,其中8例患者为根治术加术后化疗,12例患者为肿物切除术后加全身化疗,两组的5年生存率分别为23.0%和58.0%(P=0.006);其余有5例患者仅接受全身化疗,2例患者仅接受肿物切除手术.24例患者在初始治疗后取得完全缓解,1例患者部分缓解,2例患者疾病进展.随访时间1个月～10年,中位随访时间38个月.全组患者的5年总生存率和无病生存率分别是47.0%和23.0%;其中20例中高度恶性淋巴瘤患者(17例弥漫大B细胞性淋巴瘤和3例外周T细胞性淋巴瘤)的5年总生存率和无病生存率分别是48.0%和27.0%;随访中有16例复发,部位见于同侧乳腺6例、对侧乳腺4例、中枢神经系统(central nervous system,CNS)3例、骨髓1例和淋巴结侵犯2例.结论:PBL的病理类型以中高度恶性淋巴瘤为主;根治性手术在其治疗中作用有限,肿物切除术加术后化疗和放疗的效果较好.PBL患者易发生CNS复发,在随访中应定期进行颅脑CT或MR检查.     

男性乳腺霍奇金淋巴瘤一例并文献复习

目的 探讨乳腺霍奇金淋巴瘤(HL)的临床特征、诊断、治疗及影响预后的因素.方法 回顾性分析1例男性乳腺HL患者的临床资料、诊治经过及预后,并进行相关文献复习.结果 该例患者为71岁男性,临床主要表现为乳腺无痛性包块,生长较快,伴全身多处淋巴结肿大、皮肤瘙痒、盗汗,病理结果为经典型HLⅢE期B组.化疗后患者病情进展,最终死亡,生存时间7个月.结论 乳腺HL罕见,临床表现不具特异性,术前诊断困难,确诊依靠组织病理学及免疫组织化学检查.目前尚无标准治疗方案,化疗联合放疗可能有效,但预后欠佳.     

原发乳腺淋巴瘤预后分析及文献回顾

目的 分析原发乳腺淋巴瘤的临床特征,评估可行的治疗方法。 方法 回顾分析2006—2013年间本院收治的 34例原发性乳腺淋巴瘤患者临床资料。年龄 24~79岁。Ⅰ_{E期 18例,ⅡE期 16例。病理类型包括DLBCL (29例)、间变大细胞淋巴瘤(2例)、边缘区淋巴瘤(2例)、套细胞淋巴瘤(1例)。治疗方法单纯手术 2例、单纯化疗 4例、放化疗 5例、手术联合化疗 14例、手术联合放化疗 9例。采用Kaplan-Meier法计算 5年OS、PFS。 结果 26例患者存活,8例死亡(其中 7例死于淋巴瘤、1例死于化疗相关反应)。6例复发患者中 5例(83%)发生在疗后 2年内,其中 1例双乳侵犯患者在经过双侧乳腺切除及化疗后左乳复发,2例骨转移,1例肺及纵隔淋巴结转移,2例皮肤复发。5年OS、PFS率分别为75%、75%。 结论 原发性乳腺淋巴瘤是较少见的恶性肿瘤,总体预后尚可,单纯化疗或联合治疗后复发率均较低。对于现有治疗手段治疗后失败者需寻求更有效治疗方法。}     

原发纵隔大B细胞淋巴瘤1例并文献复习

原发纵隔大B细胞淋巴瘤（primary mediastinal large Bcell lymphoma,PMBL）是从20世纪80年代才被逐步认识的高度恶性非霍奇金淋巴瘤（NHL）。临床少见,约占所有NHL的5%。现将我科经病理证实的原发纵隔大B细胞淋巴瘤1例报道如下。1临床资料患者,男性,36岁,因＂胸闷2月余,加重伴气急20余     

Primary Malignant Lymphoma of the Breast： a Study of 15 Cases and Review of the Chinese Literature

OBJECTIVE To study the clinical features and significant prognostic factors for primary breast lymphoma (PBL).METHODS A retrospective clinical analysis of 15 patients with PBL and a statistical analysis of 134 cases with PBL were performed.RESULTS All 15 patients, but one, were female with a median age of 42years. None were diagnosed with PBL preoperatively. Pathological studyshowed that all cases were non-Hodgkin‘s lymphoma with the DLCL type(53.3%). The right breast was affected in 10 patients, the left in 4 and both inone. A statistical analysis showed that the size of tumors and treatmentpattern (single or multi-modality) were significant prognostic factors inpredicting the survival time, but the location of the tumor at initialpresentation and the age of the patients were not.CONCLUSION Most PBLs are NHL. The right breast is more frequently involved. The correct diagnosis depends mostly on postoperative pathology. The size of the tumor and the modality of treatment are significant prognostic factors.     

Clinical Analysis of 21 Cases of Primary Breast Malignant Lymphoma

OBJECTIVE To explore the clinico-pathological characteristics, diagnosis, treatment, and prognosis factors for primary breast malignant lymphoma (PBL). METHODS The clinical data from 21 cases of PBL were retrospectively analysed. RESULTS There were 19 females and 2 males with a median age of 37 years. All cases had diffuse non-Hodgkin lymphoma from B-cell lineage. The overall 5-year survival rate was 62.50% for the whole group and 81.82% for stage Ⅰ and Ⅱ diseases. CONCLUSION The prognosis of PBL is related to the stage and treatment modality. Operation combined with chemoradiotherapy is the best treatment method. Local resection should be the first surgical treatment.     

原发性乳腺非霍奇金淋巴瘤20例临床分析

目的:探讨原发性乳腺非霍奇金淋巴瘤(NHL)的临床特点、诊治及其预后。方法:对20例原发性乳腺非霍奇金淋巴瘤患者的临床资料进行回顾性分析。结果:20例原发性乳腺非霍奇金淋巴瘤患者中,女19例,男1例,中位年龄38岁(25~76岁),其中Ⅰ期9例(45.0%),Ⅱ期7例(35.0%),Ⅲ期3例(15.0%),Ⅳ期1例(5.0%)。1例(5.0%)为未化分型NHL,19例(95.0%)为B细胞性NHL。总的3、5年生存率分别为85.0%、65.0%,Ⅰ期 Ⅱ期3、5年生存率分别为93.75%、81.25%。结论:原发性乳腺非霍奇金淋巴瘤的预后与分期和治疗方式有关,手术 化疗综合治疗可获得较好疗效。     

Primary breast sarcoma: A review of 33 cases with immunohistochemistry and prognostic factors

The clinical and pathological features of 33 previously untreated patients with primary breast sarcoma were retrospectively analysed to evaluate the prognostic significance of histologic variables on survival. The series comprised 17 cystosarcomas phyllodes and 16 stromal sarcomas (excluding angiosarcomas).All tumors were reviewed and classified in similar fashion to extramammary soft tissue sarcomas. In addition, immunohistochemical studies were performed on paraffin sections with a panel of several antibodies directed against cytoskeletal filaments and cellular enzymes; five cases were also examined by electron microscopy.Most tumors were malignant fibrous histiocytoma (21 cases) and fibrosarcoma (6 cases) types. Surgery was the main therapy. Metastasis-free survival rate was significantly correlated only with histological grade, consisting of tumor differentiation, tumor necrosis, and mitotic activity. Courses and survivals of the cystosarcoma and stromal groups were identical, questioning the clinical value of this pathologic distinction. All local recurrence, metastasis, or death occurred within 30 months, though follow-up was much longer.Immunohistochemistry was disappointing for identification of specific histologic sub-types.     

Primary osteosarcoma of the breast in young women: One case report and literature review

Case Report A 21-year-old female with a breast tumor for over a month came to our hospital. The physical examinations on her breast showed a mammary neoplasm of about 4 cm, with a good range of motion and no abnormality seen in the skin. The patient remained single, and had no family history of breast cancer or ovarian carcinoma. CT and X-ray examinations on the osseous tissue of the whole body showed that no lesions were found. A glabrous tumor with peplos was seen during the surgery, and was completely excised.     

乳腺叶状囊肉瘤1例报告并文献复习

目的：报道乳腺叶状囊肉瘤1例,并探讨其临床病理特征、诊断及治疗方法。方法：回顾性分析1例乳腺叶状囊肉瘤患者的临床资料,结合相关文献进行病理、病因、诊断及治疗等方面的讨论。结果：本例患者曾因“乳腺纤维瘤”先后6次手术,第6次手术诊断为恶性分叶状肿瘤,术后半年出现胸壁、牙龈转移,胸壁、牙龈肿物切除术后,发现颧面部、上颌窦、胸椎多发转移,行2周期化疗,临床症状获得缓解,后因经济原因放弃治疗,随访3个月患者死亡。结论：乳腺叶状囊肉瘤由良性上皮成分和富于细胞的恶性问质成分组成,细针穿刺细胞学检查诊断价值有限,常需要手术获取完整标本,并结合免疫组化进行诊断。一旦出现复发或远处转移,应行全面检查明确病灶范围,进行综合治疗。其临床表现具有异质性,复发及远处转移者预后较差。     

Primary breast lymphoma: outcome of 7 patients and a review of the literature

Primary breast lymphomas (PBL) are uncommon neoplasms. Seven PBL were diagnosed between March 1993 and October 2002. A lumpectomy (n = 4) or radical mastectomy (n = 3) was performed; 5 patients were in clinical stage (CS) II and 2 in CS IV; 6 patients received the CEOP regimen (cyclophosphamide, vincristine, epirubicin and prednisone) after surgery and 4 also had additional radiotherapy; 1 patient did not receive any treatment after local excision. Five patients (71%) achieved complete remission and 2 (29%) partial remission, with an overall response rate of 100%. All remitter patients are alive and well after a median follow-up of 75 months (range 10 - 121 months). Two patients in partial remission died of progressive disease. After a median follow-up of 99 months (range 84 - 111 months) for surviving patients, the 10 year overall and disease-free survival rates are both 71%, with 5 patients well and still free of disease. We conclude that the optimal sequence of full-dose anthracycline-containing regimens and radiation therapy should be the treatment of choice for patients with PBL.