24例非霍奇金淋巴瘤误诊原因分析

非霍奇金淋巴瘤(NHL)由于病变部位、范围不尽相同,原发部位可在淋巴结、也可在结外淋巴组织,临床表现复杂多样,缺少特异性表现,容易误诊。我院1990年1月～1996年1月收治的非霍奇金淋巴瘤患者中,有24例在确诊前曾被误诊误治.现总结如下:     

原发结外恶性淋巴瘤47例临床分析

恶性淋巴瘤首发于淋巴结外者称结外型原发恶性淋巴瘤。由于淋巴组织遍市全身的器官组织,故结外淋巴瘤可发生于人体的各个部位,其临床表现也多种多样,所以往往被误诊为受累部位的常见病。我们自1986年12月～1998年12月共收治非霍奇金淋巴瘤(NHL)178例,其中经手术和病理证实,确诊为结外原发性NHL47例,现分析报告如下: 1 临床资料 1.1 一般资料 本组47例,男29例,女18例,男:女=1.6:1;年龄最小15岁,最大79岁,中位年龄49.5岁。从     

原发舌根非霍奇金淋巴瘤的临床分析

原发头颈部的非霍奇金淋巴瘤（non—Hodgkin lymphoma NHL）约有一半以上起源于韦氏环（waldeyer ring WR），韦氏环也叫咽淋巴环，包括舌根、双侧扁桃体、鼻咽和软腭。韦氏环属于结内部位还是结外部位目前尚有争议。在我国原发于WR的NHL的发病率高于西方，可占同期非霍奇金淋巴瘤《NHL）的23．5％，其中以扁桃体部位最常见，约占WR发病率的37％～62％，国内外对其报道较多。而原发于舌根的NHL较少见，     

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。     

原发性结外淋巴瘤42例临床及误诊分析

目的：探讨结外型恶性淋巴瘤临床特点、误诊原因及早期诊断和治疗。方法：对经病理确诊的结外非霍奇金淋巴瘤42例进行回顾性分析。结果：误诊率66．7％，发病部位以韦氏环、鼻腔最多见，其次为皮肤和胃肠道：29例行综合治疗，手术 化疗和／或放疗22例(5例联合生物治疗)，治疗 化疗7例；随访40例(95．2％)，尚有24例健在，生存5年以上者8例，Ⅰ、Ⅱ期占75．0％。结论：结外型淋巴瘤易误诊，临床表现缺乏特异性，韦氏环、鼻腔及皮肤最易受侵犯，病理检查是确诊的唯一方法；早期诊断、早期治疗预后较佳。     

鼻咽非霍奇金淋巴瘤12例临床分析

目的探讨鼻咽非霍奇金淋巴瘤的发病率、疗效及预后。方法回顾分析鼻咽非霍奇金淋巴瘤12例的临床资料。结果本病占恶性淋巴瘤的3．43％，占结外淋巴瘤的12．9％，高度恶性占75％(9／12)，T细胞占66．7％(8／12)。临床表现为鼻塞、鼻腔恶臭异味、鼻涕带血、发热。全部误诊。CR9例，PR2例，PD1例，有效率(CR PR)为91．7％(11／12)。2、5年生存率分别为77．8％、71．4％。结论鼻咽非霍奇金淋巴瘤临床少见，极易误诊。本病疗效较好，但高度恶性、T细胞型并伴有发热症状者预后差。     

呼吸系统原发性淋巴瘤11例临床分析

目的 了解呼吸系统原发性淋巴瘤(PLRS)的临床病理特点及治疗结果。方法 分析11例患者的临床表现、影像学改变、病理类型、治疗及生存情况。结果 原发于气管2例，原发于肺9例。临床表现主要为咳嗽胸闷、发热，胸片和胸部CT扫描表现为肿块或阴影。病理类型为霍奇金病(HD)2例；非霍奇金淋巴瘤(NHL)9例，包括低度恶性7例，其中黏膜相关淋巴瘤5例(55．6％)，中度恶性2例。10例行手术治疗，8例术后加化疗，2例术后加放疗。治疗后2例HD患者的无病生存期超过5年，黏膜相关淋巴瘤和其它类型的NHL，中位生存期分别为39个月和34个月。结论 PLRS的临床和影像学表现为非特异性，病理类型以低度恶性黏膜相关淋巴瘤多见，外科手术为治疗首选，预后良好。     

早期鼻腔及韦氏环非霍奇金淋巴瘤13例临床分析

目的探讨早期鼻腔、韦氏环非霍奇金淋巴瘤（NHL）的临床特点和近期疗效。方法回顾性分析2002年11月至2005年1月收治的经病理证实的13例早期鼻腔、韦氏环非霍奇金淋巴瘤的临床资料。结果鼻腔、鼻咽部病变多数以鼻塞、吸涕带血为首发症状,仅1例以耳部症状首发,口咽部则以咽痛、咽部不适多见,临床易延误诊断。11例接受化疗＋放疗,2例接受单纯放疗CR10例,PR3例,总有效率为100％。结论鼻腔、韦氏环是结外NHL中最常见的受累部位,临床表现缺乏特异性,易延误诊断,确诊需病理。近期疗效满意。     

原发性结外淋巴瘤136例临床分析

目的 探讨原发性结外淋巴瘤(PENL)的临床特点、诊断及治疗。方法 回顾性分析136例PENL的临床资料。结果 136例患者均为非霍奇金淋巴瘤(NHL)，PENL占同期收治恶性淋巴瘤病例的52．9％(136／257)。41.2％(56／136)的PENL病灶在头颈部，26．5％(36／136)的PENL病灶在胃肠道，86．0%(117／136)的PENL表现为原发器官肿大或局部肿块形成，接受化疗、放疗等治疗的患者病情均有不同程度好转。结论 PENL主要为非霍奇金淋巴瘤，PENL好发于头颈部及胃肠道，患者主要表现为原发器官的肿大及局部肿块形成，化疗及放疗有较好疗效。     

原发性结外恶性淋巴瘤10例及误诊原因分析

目的：探讨结外恶性淋巴瘤误诊原因。方法：对10例结外恶性淋巴瘤的原发部位、就诊时间、临床表现、病理类型及转移情况进行分析，结论：结外恶性淋巴瘤因发生率低，临床症状无特异性，术中与常见肿瘤形态相似等，是其误诊的原因。     

原发性骨淋巴瘤的影像学及临床病理特征

 原发性骨淋巴瘤（PLB）为非霍奇金淋巴瘤（NHL），是一类罕见的结外淋巴瘤，占所有NHL的1 %、结外淋巴瘤的5 %、原发于骨的恶性肿瘤的7 %。目前公认的PLB诊断标准为：肿瘤局限于单骨，临床和影像学检查未发现有其他系统病灶；病理组织学上确诊骨病灶为淋巴瘤；就诊时只有局部浸润，或至少在原发灶出现6个月后才有远处骨骼和其他部位的转移。由于PLB 表现的多样性和异质性，且发病率较低，导致诊断困难，现分析归纳其临床病理及影像学特征，以提高认识，降低误诊和漏诊率。     

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.     

Multifocal extranodal non-hodgkin lymphoma: a clinicopathologic study of 37 cases in Greece, a Hellenic Cooperative Oncology Group study

The purpose of this retrospective study was to illustrate the clinicopathological features of patients presenting with multifocal extranodal non-Hodgkin lymphoma (NHL). Among 810 patients with NHL, 37 cases (4.2%) were found to have multiple extranodal involvement (two or more sites). There were 24 men and 13 women, with a median age of 63 years. The majority of these cases (n = 26) had gastric or intestinal (GI) involvement with or without other extranodal sites. Lung along with another extranodal site was relatively common in the present series. Stratification of the 37 cases according to the International Prognostic Index (IPI) showed that 89% of the patients belonged to the high-risk groups. Diffuse large-B-cell lymphoma (DLBCL) accounted for 62%, and mucosa-associated lymphoma tissue (MALT) lymphoma accounted for 27% of all cases. After induction treatment with anthracycline-based regimens, complete remission was achieved in 21 patients (57%), partial remission was achieved in six patients (16%), and seven patients (19%) had no response, while three patients (8%) were nonevaluable. In conclusion, multifocal extranodal NHL is a heterogeneous group of diseases. The majority of them arise at various sites in the GI tract. DLBCL was the most frequent histological subtype followed by MALT lymphoma. Risk group, as defined by the IPI, was predictive of survival.     

Primary Extranodal Non-Hodgkin’s Lymphoma: Clinicopathological Features,Survival and Treatment Outcome in Two Cancer Centers of Southern Turkey

Background: The aim of this study was to assess the epidemiological and clinicopathological characteristics of primary extranodal non-Hodgkin’s lymphoma (pENL) patients, focusing on treatment and survival outcome. Materials and Methods: Between October 2003 and March 2012, 802 patients with non-Hodgkin’s lymphoma (NHL) were diagnosed and treated in two different cancer centers of Southern Turkey. Results: pENL, constituted 12.4% (100/802) of all NHL studied during this period. Median age of the patients was 56 years (range 17-87 years) and the male: female distribution was 3:2. Eighty-five of 100 patients (85%) were in stage I/II, 9/100 (9%) in stage III, whereas 6/100 (6%) were in stage IV. Head and neck constituted the most common site (51/100, 51%), followed by gastrointestinal tract (GIL) (37/100, 37%), and cerebrum (CL) (5/100, 5%). Diffuse large B cell lymphoma (DLBCL) was the most common histological type, observed in 53% of patients, followed by marginal zone extranodal lymphoma (13%). Most of patients (76%) received a CHOP containing regimen. Complete remission (CR) were achieved in 71% of patients. The median follow-up duration of all patients was reported as 37.6 months (range, 0.8-165 months). This period was reported as 137.5 months (range, 117.5-1578.6 months) in gastrointestinal lymphoma (GIL) patients, 119.0 months (range, 91.8-146.1 months) in headand neck lymphoma (HNL) patients, and 18.4 months (range, 12.6-24.1 months) in cerebral lymphoma (CL) patients. Conclusions: Head and neck, and the gastrointestinal tract were the two most common extranodal sites observed. Histologically DLBC accounted for the majority of cases. Most patients were on earlier stages, had low-low intermediate IPI scores and had a favorable prognosis.     

Non-Hodgkin lymphoma in Chile: a review of 207 consecutive adult cases by a panel of five expert hematopathologists

The distribution of subtypes of non-Hodgkin lymphoma (NHL) in Latin America is not well known. This Chilean study included 207 consecutive cases of NHL diagnosed at five cancer centers in the capital, Santiago, and one center in Vi?a del Mar. All cases were reviewed and classified independently by five expert hematopathologists according to the 2001 World Health Organization classification of NHL. A consensus diagnosis of NHL was reached in 195 of the 207 cases (94%). B-cell lymphomas constituted 88% of NHL, and diffuse large B-cell lymphoma (DLBCL, 38.5%) and follicular lymphoma (25.1%) were the most common subtypes. There was a high frequency of marginal zone B-cell lymphoma (10.3%), as well as of extranodal natural killer (NK)/T-cell lymphoma, nasal type (2.6%) and adult T-cell leukemia/lymphoma (0.5%). Extranodal presentation was seen in 74 of the 195 cases (38%) and the most common extranodal presentation was in the stomach (37.6%). The most common gastric lymphoma was DLBCL (54.5%) followed by mucosa-associated lymphoid tissue (MALT) lymphoma (41%). Overall, the frequency of NHL subtypes in Chile is between that reported in Western and Eastern countries, which is probably a reflection of the admixture of ethnicities as well as the environment and socioeconomic status of its population.     

Clinicopathological features of extranodal lymphomas: Kuwait experience

A total of 935 patients with extranodal non-Hodgkin lymphoma (NHL) diagnosed in the period between January 1985 and December 2000 in Kuwait Cancer Center, serving the whole population of Kuwait, were used to describe the clinicopathological and epidemiological features of extranodal lymphomas in Kuwait. Extranodal lymphomas accounted for 45% of all NHL observed during this time. All NHL cases from Kuwait Cancer registry were analyzed and pathologically reclassified using the latest WHO (2000) classification. The most common lymphoma observed was diffuse large B-cell lymphoma (58.60%) followed by Burkitt s lymphoma (BL) (3.80%). In the pediatric group, BL comprises more than two thirds of all patients (77.20%). The most common extranodal sites were stomach (19.70%) and skin (17.80%) in the adult group, large intestine (29.80%) and small intestine (19.30%) in the pediatric age group. The majority (73.40%) of adult extranodal lymphomas was in stage IE-IIE and had a very good prognosis. On the contrary, the majority of pediatric extranodal lymphomas were found to be in stage III and IV. Variations in treatment policies (single agent or combined chemotherapy, radiotherapy, combined modality treatment) adopted and changed during the time period of 16 years of this retrospective study were documented.     

Oral Extranodal Non Hodgkin’s Lymphoma: Series of Forty Two Cases in Malaysia

Background: Lymphoma is a malignant neoplasm of lymphoid tissue classified into Hodgkin’s and non-Hodgkin’s types. It mostly affects lymph nodes although a considerable proportion of Non-Hodgkin’s casesoccur in extranodal sites. Materials and Methods: Selected cases diagnosed as non-Hodgkin’s lymphoma (NHL)during the period of 1980 to 2012 were retrieved from the archives of the Oral Pathology Diagnostic Laboratory,Faculty of Dentistry, University of Malaya. The sections from the formalin-fixed paraffin embedded tissue blockswere stained with H&E as well as with LCA, CD20, and CD3. Results: The mean age was 41.6 years with amale: female ratio of 1.3:1. Out of the forty two cases, nineteen were Malays, eighteen were Chinese, followedby Indians (3) and Indonesians (2). The most common site of involvement was the mandible (22.2%), followedby the maxilla and palate (19.4% each). Most of the lesions presented as a painless progressive swelling. Onlythirty six cases were further subdivided into B or T cell types. The majority were B-cell type (26 cases), of these 6cases were Burkitt’s lymphomas. Only ten cases were T-cell lymphoma, with three cases of NK/T-cell lymphoma.Conclusions: In this series of 42 patients diagnosed as extranodal non-Hodgkin’s lymphoma, the lesions appearedas painless swellings, mostly in men with the mandible as the most frequent site of involvement. Majority wereB-cell lymphomas with Malays and Chinese being equally affected whereas lymphomas were rare in the Indianethnicity. T-cell lymphomas were found to be common in the Chinese ethnic group.     

青海地区淋巴瘤253例临床特点与预后因素分析

目的 分析淋巴瘤的临床特点及预后相关因素.方法 对青海地区253例淋巴瘤患者临床资料进行回顾性研究并随访.采用Kaplan-Meier法分析患者不同临床特点及实验室检查的生存期差异.采用Cox比例风险回归模型分析影响预后的因素.结果 253例淋巴瘤患者中,男、女比例为1.56∶1,中位年龄为48岁,发病年龄高峰为40岁和60岁左右.结内起病（56.13％）较多,结外起病常见部位为鼻咽部和胃肠道.病理类型为霍奇金淋巴瘤40例（15.81％）,非霍奇金淋巴瘤213例（84.19％）.前者以结节硬化型（72.50％）最多见;后者中B细胞淋巴瘤148例（69.48％）,最常见的病理类型为弥漫大B细胞淋巴瘤（39.91％）、滤泡细胞淋巴瘤（12.21％）及周围T细胞非特殊型淋巴瘤（9.39％）.单因素预后分析显示,临床分期、有无B症状、血红蛋白（Hb）、乳酸脱氢酶（LDH）、国际预后指数（IPI）及治疗方案与非霍奇金淋巴瘤预后密切相关（均P＜0.05）.Cox回归模型多因素分析显示,临床分期、IPI及治疗方案与非霍奇金淋巴瘤的预后关系密切,差异有统计学意义（均P＜0.05）.结论 青海地区淋巴瘤发病年龄有两个高峰,结内发病高于结外,B细胞淋巴瘤多见,IPI分组适用于该地区非霍奇金淋巴瘤的预后评估,并可作为其独立的预后因素.     

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。     

原发胃肠道非霍奇金淋巴瘤的研究现状

胃肠道是原发结外非霍奇金淋巴瘤（non-Hodgkin's lymphoma,NHL）最常见的发病部位,发病率逐年上升。虽然结内非霍奇金淋巴瘤的治疗模式已标准化,但是对于原发胃肠道非霍奇金淋巴瘤的治疗仍存在争议。手术、化疗、放疗等治疗方式可单独应用,或以不同组合联合应用,最佳治疗模式目前尚无定论,且影响原发胃肠道非霍奇金淋巴瘤预后的因素较多。现对原发胃肠道非霍奇金淋巴瘤的发病率、临床特点、组织学分类、治疗方案及预后进行综述,重点探讨该病的治疗及预后。