原发乳腺非霍奇金淋巴瘤1例并文献复习

目的提高临床及辅助科室医生对原发乳腺非霍奇金淋巴瘤(PBNHL)的认识,拓展思路,避免误诊。方法对1例PBNHL患者的临床资料进行回顾性分析,并复习国内外有关文献。结果患者因"发现左乳肿物1周"入院,临床拟诊为左乳乳腺癌。乳房彩超扫查及钼靶X线摄片均提示肿物倾向恶性。左乳房肿物穿刺活检提示:PBNHL(左),弥漫大B细胞性,生发中心细胞型。行左乳房单纯切除+左腋窝淋巴结清扫+血管探查术,并转肿瘤内科进一步治疗。结论 PBNHL临床罕见,临床症状及影像学表现无特异性,容易误诊。病理学检查及免疫组化是诊断PBNHL的金标准。     

双侧睾丸非霍奇金淋巴瘤1例报告

睾丸淋巴瘤属睾丸继发性肿瘤,在睾丸肿瘤中所占比例较小。2006年6月本院收治1例双侧睾丸淋巴瘤,现报告如下。     

原发性膀胱非霍奇金淋巴瘤1例报告并文献复习

目的:探讨原发性膀胱非霍奇金淋巴瘤(NHL)的病因、病理、临床表现、诊断与治疗及预后。方法:回顾性分析我院收治的1例原发性膀胱NHL患者的临床资料,并结合文献进行探讨。结果:患者以肉眼血尿为主要症状,行手术切除,病理及免疫组织化学证实为NHL,术后辅助以化疗及放疗。结论:原发性膀胱NHL十分罕见,高度恶性,以肉眼血尿为最常见的临床症状,FDG-PET及CT对诊断有一定作用,确诊需要病理及免疫组织化学检查,治疗主要以手术切除并辅助术后放疗、化疗,并需定期复查,预后差。     

输尿管非霍奇金滤泡性淋巴瘤1例报告并文献复习

目的:探讨输尿管非霍奇金滤泡性淋巴瘤的病因、临床表现、诊断及治疗。方法:回顾分析本院收治的1例输尿管非霍奇金滤泡性淋巴瘤患者的临床资料,术前诊断:左输尿管下段占位,左肾积水。行左输尿管病变段探查术,术中冷冻切片诊断为淋巴瘤,遂行输尿管端端吻合术。结果:术后病理回报证实输尿管非霍奇金滤泡性淋巴瘤、Ⅰ~Ⅱ级。术后随访3个月,未见肿瘤复发及转移,生存状态良好。结论:输尿管非霍奇金滤泡性淋巴瘤是一种极罕见的肿瘤,确诊需行内镜检查及活检,手术切除肿瘤段,解除梗阻,并尽可能保留肾功能是其首选治疗方法。     

原发性肝脏非霍奇金淋巴瘤1例报告暨文献复习

目的探讨原发性肝脏非霍奇金淋巴瘤的相关诊断与治疗。方法回顾性分析我院近期收治原发性肝脏非霍奇金淋巴瘤1例患者的临床资料,并进行相关文献复习。结果患者在全麻下施行右肝后叶＋Ⅸ段切除术,术中见无瘤肝脏质地好,无肝硬化表现,肿物约14cm×11cm×9cm。术后病理检查提示为原发性肝脏非霍奇金淋巴瘤,B细胞来源。术后患者恢复顺利,8d后拆线,转血液内科行一疗程R—CHOP方案化疗后出院。结论原发性肝脏非霍奇金淋巴瘤罕见且无特异性表现,因此其诊断较为困难,手术为其有效治疗方法,但就现有认识而言,仍需进一步加强相关研究及认识。     

原发性肾上腺非霍奇金淋巴瘤7例报道

目的:研究原发性肾上腺淋巴瘤(PAL)的临床特征及诊治方法。方法:回顾性分析7例PAL患者的临床症状,影像学表现等资料,结合相关文献分析其诊治及临床效果。结果:7例中5例行手术治疗并接受化疗,2例随访1年健在,3例分别于术后2、6、9个月死亡。未手术治疗2例接受化疗,分别于出院后6、8个月死亡。结论:PAL缺乏典型临床及影像学表现,FDG-PET在诊断上具有优势;预后差,合并肾上腺皮质功能低下的患者更差;手术联合化疗效果优于单一治疗。     

原发性胆总管非霍奇金淋巴瘤1例并文献复习

目的:探讨原发性胆总管非霍奇金淋巴瘤(NHL)的临床病理特征、诊治及预后。方法:报道广西医科大学附属肿瘤医院收治的1例原发性胆总管NHL患者,并结合1982—2017年间国内外文献报道的34例原发性胆总管NHL患者资料进行分析。结果:该患者为男性,81岁,行胰十二指肠切除术后病理结果证实原发性胆总管NHL(弥漫性大B细胞淋巴瘤),术后未行全身化疗及局部放疗等辅助抗肿瘤治疗,4个月后复查未见肿瘤复发。该例加上报道的34例患者中男21例(60.0%),女14例(40.0%);发病年龄4~81岁,中位年龄57岁;临床表现有黄疸(88.6%)和腹痛(40.0%),体表淋巴结肿大(11.4%),伴发热(11.4%);部分影像学表现为胆总管占位或者胆总管壁增厚狭窄;4例行全身化疗,10例行手术切除,16例行手术切除联合全身化疗,1例行手术切除联合局部放疗,3例行手术切除联合全身化疗及局部放疗,1例治疗方案未知。大部分患者治疗后预后较好,有1例生存期超过72个月;单纯手术切除患者与单独化疗或其他联合治疗患者的生存期差异无统计学意义(均P0.05)。结论:原发性胆总管NHL为临床罕见疾病,缺乏典型的临床表现,实验室及影像学检查无明显特异性,故其临床诊断困难,确诊依赖于术后病理学与免疫组织化学,选择合适的治疗方案是延长患者生存期的关键。     

原发性肾上腺淋巴瘤二例报告

目的 探讨原发性肾上腺淋巴瘤的诊断和治疗.方法 原发性肾上腺淋巴瘤患者2例.例1,男,58岁.临床表现为发热、乏力3个月.CT检查示双肾上腺区软组织肿块,右侧2.0 cm×6.0 cm,左侧4.0 cm×7.2 cm,轮廓清,腹膜后未见肿大淋巴结.胸部X线检查、血常规化验未见异常.例2,男,32岁.临床表现为发热3周.CT检查示双肾上腺体积弥漫性增大,右肾上腺区2.5 cm×3.6 cm肿块,腹膜后未见肿大淋巴结.胸部X线检查、血常规化验未见异常.结果例1行后腹腔镜下右肾上腺切除术.肿物剖面呈暗紫色.镜下瘤细胞呈圆形或卵圆形,细胞异形性明显,可见核分裂象.免疫组化染色:CD20、CD45 RO、胎盘碱性磷酸酶(PLAP)阳性.病理诊断:大B细胞恶性淋巴瘤.予CHOP方案(环磷酰胺、表阿霉素、长春新碱及泼尼松)化疗1周期,患者呈明显恶液质,自动出院后2个月死亡.例2行后腹腔镜下双肾上腺切除术.肾上腺剖面呈腐肉样,质脆.镜下瘤细胞弥漫分布,呈圆形或多角形,胞质少,核仁明显.免疫组化染色;CD3、CD45RO阳性,CD20.阴性.病理诊断:T细胞非霍奇金淋巴瘤.CHOP方案化疗4周期,随访5个月,一般情况良好.结论原发性肾上腺淋巴瘤临床罕见,尤其是T细胞型非霍奇金淋巴瘤,手术加化疗或放疗效果优于单一治疗. 碱性磷酸酶(PLAP)阳性.病理诊断:大B细胞恶性淋巴瘤.予CHOP方案(环磷酰胺、表阿霉素、长春新碱及泼尼松)化疗1周期,患者呈明显恶液质,自动出院后2个月死亡.例2行后腹腔镜下双肾上腺切除术.肾上腺剖面呈腐肉样,质脆.镜下瘤细胞弥漫分布,呈圆形或多角形,胞质少,核仁明显.免疫组化染色;CD3、CD45RO阳性,CD20.阴性.病理诊断:T细胞非霍奇金淋巴瘤.CHOP方案化疗4周期,随访5个月,一般情况良好.结论原发性 上腺淋巴瘤临床罕见,尤其是T细胞型非霍奇金淋巴瘤,手术加化疗或放疗效果优于单一治疗. 碱性磷酸酶(PLAP)阳性.病理诊断:大B细胞恶性淋巴瘤.予CHOP方案(环磷酰胺、表阿霉素、长春新碱及泼尼松)化疗1周期,患者呈明显恶液质,自动出院后2个月死亡.例2行后腹腔镜下双肾上腺切除术.肾上腺剖面呈腐肉样,质脆.镜下瘤细胞弥漫分布,呈圆形或多角形,胞质少,核仁明显.免疫组化染色;C     

胸椎原发非霍奇金淋巴瘤1例报告及文献复习

1 病历摘要 儿童脊柱椎体破坏,首先考虑诊断为椎体结核,其次为骨嗜酸性肉芽肿、转移瘤等.临床上原发脊柱椎体非霍奇金恶性淋巴瘤病例十分罕见,现报道如下.患者女,6.5岁,以"间歇性低热、伴腰痛半年,双下肢不全瘫1个月"就诊.X线片发现T9椎体破坏,诊断为"胸椎结核",并于抗结核治疗两周后,入院接受治疗.     

肾原发性淋巴瘤二例报告并文献复习

目的探讨肾脏原发性恶性淋巴瘤的临床病理特点、影像学特征及诊治。方法总结2例肾脏原发性淋巴瘤患者的临床病理、影像学特点、诊断、鉴别诊断及治疗预后资料,并结合文献复习讨论。结果2例患者均为中老年人,发病后均有腰部隐痛或钝痛;影像学检查均显示肾脏占位性病变;病理诊断均为肾脏原发性恶性淋巴瘤,其中1例为霍奇金淋巴瘤（以结节硬化型为主）,1例为非霍奇金淋巴瘤（B细胞性）。1例行手术加化疗,1例单纯化疗;患者预后佳,目前分别存活1年和5年8个月。结论肾脏原发性恶性淋巴瘤十分罕见,尤其是霍奇金淋巴瘤;确诊需病理组织学检查,治疗主要是单纯化疗或根治性肾切除加化疗。     

肾上腺恶性孤立性纤维性肿瘤（1例报告并文献复习）

目的 结合病例报告及文献复习,探讨肾上腺恶性孤立性纤维性肿瘤（malignantsolitary fibrous tumor,MSFT）的临床特征、治疗方案及预后.方法 对本院收治的1例肾上腺恶性孤立性纤维性肿瘤进行回顾性分析,并使用关键词”“孤立性纤维性肿瘤”检索“中国生物医学文献数据库”,同时使用Pubmed数据库检索“solitary fibrous tumor and adrenal”,对所得文献进行复习,对所有诊断为恶性孤立性纤维性肿瘤进行汇总分析.结果 检索国内孤立性纤维性肿瘤文献共有241篇报道,其中病例报道130篇,恶性肿瘤有13篇,未见肾上腺MSFT个案报道.Pubmed结果提示目前共有5例孤立性纤维性肿瘤.结论 肾上腺MSFT非常罕见,可发生在身体任何部位,确诊主要依靠病理形态学及免疫组化,治疗方案主要为手术切除,必要时可行术后放化疗,预后较差.     

Primary laryngeal T-cell lymphoma: A case report and review of the literature

IntroductionPrimary lymphoma of the larynx is extremely rare, representing less than 1% of all primary laryngeal neoplasms. It consists mainly of non-Hodgkin lymphomas (NHLs), represented particularly by diffuse large B-cell. Extranodal natural killer/T-cell lymphoma, presented in larynx is a rare condition that accounts for less than 11% of all lymphomas without distinctive clinicopathologic features, as well as challenging pathologic diagnosis.Case reportWe report here a case of a 64-years-old man who presented with primary lymphoma type T of the subglottic larynx. A histopathological examination of the biopsy confirmed non-Hodgkin T cell lymphoma. Given his age, he underwent chemotherapy and radiation therapy. The patient was disease-free after 18 months follow up.ConclusionThe clinicopathological characteristics and rational treatment of primary laryngeal lymphoma are still unclear and need to be further defined due to the paucity of this pathology.     

Breast lymphoma in a patient with B-cell Non Hodgkin Lymphoma: A case report study

IntroductionBreast involvement in Non Hodgkin Lymphoma is a rare entity as it accounts for 2.2% of all extranodal lymphomas.Presentation of caseA 59-year-old woman was referred to our Breast Unit because of two nodules of the right breast newly discovered during her annual mammography. Moreover, during the physical examination, a red-brown itchy lump of the scalp was discovered. The punch biopsies of the scalp lesion and ultrasound-guided core biopsies of both nodules of the right breast, revealed the presence of diffuse large B-cell Non Hodgkin Lymphoma in all tissue specimen sites.DiscussionBreast lymphomas represent an uncommon form of localized extranodal lymphomas that can be classified as Primary (PBL) or Secondary (SBL) breast lymphomas.ConclusionThe value of preoperative diagnosis should be underlined as the patient avoids unnecessary surgical intervention and has earlier initiation of chemotherapy.     

肾上腺、泌尿男生殖系统恶性淋巴瘤的诊断和处理(附4例报告)

目的 提高肾上腺、泌尿男生殖系恶性淋巴瘤的诊治水平.方法 报告收治的4例患者的临床资料,4例的临床表现和影像学检查均无特异性.2例经手术探查明确诊断,2例在B超导引下行穿刺活检后明确诊断.3例常规行化疗.结果 例1术后随访11月至今,目前仍存活.例2目前已存活4年例3现已存活2年.例4诊断后20天,死于脑转移、肺部感染、感染性休克、呼吸循环衰竭.结论 临床表现和影像学检查缺乏特异性,手术探查、CT或超声导引下的穿刺活检是明确诊断的好方法,治疗要根据病理组织类型和分期的个体化治疗.     

Concurrent FSGS and Hodgkin's lymphoma: case report and literature review on the link between nephrotic glomerulopathies and hematological malignancies

Background The link between the nephrotic syndrome (NS) and malignancy was first described in 1922. In solid tumors, the NS is most often due to membranous glomerulonephropathy, whereas in common hematological malignancies, minimal-change disease predominates. Focal segmental glomerulosclerosis (FSGS) is among the least frequently reported renal lesion associated with malignancy. Methods We report a case of the simultaneous diagnoses of FSGS and Hodgkin's lymphoma, and review the literature on various nephrotic glomerulonephropathies associated with common leukemia and lymphoma. Results Although nephrotic glomerulonephropathies rarely occur in association with acute leukemia, they have often been described in chronic lymphocytic leukemia (CLL). Membranoproliferative glomerulonephropathy and membranous glomerulonephropathy are the most common lesions observed in CLL. Nephrotic glomerulonephropathies have also been well documented among patients with lymphomas, in particular, Hodgkin's lymphoma. While minimal-change disease is most commonly found in association with Hodgkin's lymphoma, more diverse and complex renal lesions are associated with non-Hodgkin's lymphoma. FSGS remains a rare association with hematological malignancies. Conclusions Nephrotic glomerulonephropathies are not only linked to solid-organ tumors, but also to hematolo-gical malignancies. A thorough evaluation, including a physical examination for lymphadenopathy and organomegaly, as well as a hematological evaluation, must be performed in all patients presenting with nephrotic glomerulonephropathies.     

肾脏原发性淋巴瘤一例报告并文献复习

目的 提高肾脏原发性淋巴瘤的诊治水平.方法 回顾性分析1例肾脏原发性淋巴瘤患者的临床病理资料,结合文献复习讨论.患者,女,61岁.因左侧腰痛2周入院.查体:左上腹压痛,左肾区叩击痛.B超检查见左肾正常结构未显示,集合系统分离,最宽处约1.0 cm,左肾区可探及一巨大低回声肿物,大小9.7cm×5.3cm,边界模糊.CT检查见左肾中下极肿物,大小9.8 cm×8.9 cm ×8.8 cm,边界不清,平扫CT值为39 HU,增强后为61 HU,强化不明显.术前诊断:左肾恶性肿瘤.结果 患者行根治性左肾切除术.病理报告:左肾大部分被肿瘤组织占据,中下极见10.0cm×9.5 cm ×8.5 cm类圆形肿物,质硬,肿物切面呈灰白色,质地细腻.镜下瘤细胞呈弥漫性浸润,卵圆形或多边形,略大于正常淋巴细胞,核大深染呈不规则形.病理诊断:肾弥漫性大B细胞性淋巴瘤.骨髓穿刺检查未见异常.行环磷酰胺+吡喃阿霉素+长春新碱+泼尼松+利妥昔单抗方案化疗6周期.术后每3个月复查胸部X线片、腹部B超及CT等.随访20个月,未见肿瘤复发.结论 肾脏原发性淋巴瘤临床罕见,症状与肾癌相似,影像学检查无特征性改变,确诊需依靠病理学检查.本病预后不良,手术切除患肾联合规范的全身化疗,可延长患者的生存期.     

Adrenal pseudocyst: Diagnosis and laparoscopic management - A case report

Cysts of the adrenal gland are rare and are usually discovered incidentally. Large adrenal cysts can however present with severe abdominal pain and can be complicated by haemorrhage, rupture or infection. Adrenal pseudocysts appear to result from haemorrhage within a normal adrenal gland and can expand to accommodate massive amounts of fluid.We report the case of a 39-year-old woman who presented with worsening right upper quadrant pain. An ultrasound scan of the abdomen confirmed a large 29 cm × 20 cm × 17 cm cyst that appeared to originate in the upper pole of the right kidney causing displacement of the liver and right kidney.Following complete aspiration the cyst re-accumulated and an MRI scan demonstrated a thickened and irregular cyst wall with haemorrhagic fluid. Laparoscopic right adrenalectomy was performed and the histopathological diagnosis was confirmed as an adrenal pseudocyst.     

Adrenal myelolipoma: A case report and review of the literature

A case of a 73 year old man who was preoperatively diagnosed as possibly having adrenal myelolipoma is presented herein. Adrenal myelolipoma is an uncommon benign tumor of which only 74 foreign cases and 43 Japanese cases have been previously reported in the literature dealing with surgically removed myelolipomas. The most consistent complaint of the adrenal myelolipoma sufferer is abdominal pain, caused by hemorrhaging in the tumor, and many cases are associated with obesity, hypertension and/or diabetes mellitus. There is now an increasing number of such cases being diagnosed during abdominal scanning with ultrasonography or computerized tomography for unrelated problems, whereupon the myelolipoma is usually surgically resected. With the availability of modern scanning techniques and fine needle biopsy, however, it should be possible to adopt a more conservative approach to the management of asymptomatic adrenal myelolipoma. Nevertheless, symptomatic or large tumors, must be removed since there is a high risk of spontaneous hemorrhage.     

后腹腔镜技术治疗肾上腺肿瘤53例报告

目的 总结后腹腔镜技术治疗肾上腺肿瘤的经验,提高其临床应用水平.方法 2002年6月至2009年10月为53例患者施行后腹腔镜肾上腺肿瘤切除手术.其中原发性醛固酮增多症19例,皮质醇增多症8例,嗜铬细胞瘤9例,无功能腺瘤14例,肾上腺囊肿2例,肾上腺神经节细胞瘤1例.本组患者术前均经超声、CT或MRI等证实为肾上腺占位性病变.病变位于左侧33例,右侧20例.瘤体直径1.2-7.0cm,平均2.2cm.结果 49例完成手术,4例中转开放手术.手术时间56～220min,平均92min.术中出血量约20-300ml,平均55ml.术后住院时间4～12d,平均7d.术后未发生严重并发症.结论 后腹腔镜肾上腺肿瘤切除术安全,有效,创伤小,恢复快,应为肾上腺良性疾病的首选治疗方法.