恶性淋巴瘤骨髓侵犯相关因素分析

目的 探讨恶性淋巴瘤骨髓侵犯的相关因素。方法分析恶性淋巴瘤骨髓侵犯57例初治患者的临床资料。结果恶性淋巴瘤骨髓侵犯与患者的年龄、病理类型、临床分期、受累部位、有无全身症状、病程等有关，年龄以30岁以下为多(50％)，病理类型以小淋巴细胞型及弥漫型裂细胞、淋巴母细胞、大细胞多见(84％)，临床分期以Ⅲ期、Ⅳ期为多(95％)，受累部位以纵隔及脾脏为多(44％、32％)，有全身症状者占63％，平均病程4．5月，45例NHL骨髓侵犯(BMI)患者仅有3例外周血象异常。结论恶性淋巴瘤患者年轻、病理类型差、临床分期晚、纵隔及脾脏受累、有全身症状、病程长者易出现骨髓侵犯，但BMI患者外周血象不能提示骨髓侵犯。为正确分期和指导临床治疗，应常规行骨髓涂片检查。     

54例小儿恶性淋巴瘤临床病理分析

通过对５４例小儿恶性淋巴瘤的临床病理分析，对小儿恶性淋巴瘤的诊断、组织学类型特点及与发病年龄、部位、临床分期和愈后关系进行了讨论，结果提示小儿非霍奇金淋巴瘤和霍奇金淋巴瘤二者的发病年龄、临床表现、部位和愈后均有所不同。     

儿童原发性骨淋巴瘤11例并文献复习

目的探讨儿童原发性骨淋巴瘤的临床表现、病理类型、治疗及预后等。方法回顾性分析首都医科大学附属北京儿童医院2016年1月至2020年1月收治的11例初诊为原发性骨淋巴瘤患儿的临床资料, 包括性别、发病年龄、原发受累部位、临床分期、病理类型、是否骨折及临床转归等, 并复习相关文献。结果 11例患儿均为初治原发性骨淋巴瘤, 中位发病年龄8.6岁(2.7～12.3岁), 其中男性7例, 女性4例;弥漫大B细胞淋巴瘤(DLBCL)7例, B淋巴母细胞淋巴瘤(BLL)3例, 间变性大细胞淋巴瘤(ALCL)1例;首发症状为骨痛8例, 局部肿胀1例, 跛行1例, 发热1例;临床分期Ⅰ期1例, Ⅱ期7例, Ⅳ期3例;最常见的受累部位为股骨、胫骨。所有患儿均依据不同病理类型接受化疗, 中位随访时间45个月(7～80个月)。10例完全缓解, 1例BLL患儿化疗缓解后因骨髓复发死亡。结论儿童原发性骨淋巴瘤临床表现隐匿, 以DLBCL多见, 接受规范治疗预后良好。     

原发性甲状腺恶性淋巴瘤27例临床分析

  【摘要】　目的　探讨原发性甲状腺恶性淋巴瘤的临床特点及治疗方法。方法　回顾性分析27例原发性甲状腺恶性淋巴瘤患者的临床资料。结果　27例原发性甲状腺恶性淋巴瘤病理类型均为B细胞型,多为低度恶性的结外边缘区B细胞淋巴瘤,临床分期均为Ⅰ、Ⅱ期,予以合理综合治疗,预后相对较好。结论　原发性甲状腺恶性淋巴瘤应强调综合治疗,外科手术主要起协助诊断的作用,术后放疗与化疗是必要的。     

原发性甲状腺恶性淋巴瘤28例临床分析

背景与目的：原发性甲状腺恶性淋巴瘤很少见,其临床治疗方案和预后评判尚无统一标准。本文探讨原发性甲状腺恶性淋巴瘤的临床表现、诊断、治疗和影响预后的主要因素。方法：回顾28例原发性甲状腺恶性淋巴瘤患者的一般临床资料、临床病理分型、治疗方法、组织病理分型,并结合随访资料进行分析。结果：不足40岁组3例均为腺内型;40～60岁组9例中7例为腺内型,2例为腺外型;60岁以上组16例中,7例为腺内型,9例为腺外型。有随访的24例原发性甲状腺恶性淋巴瘤的中位随访期3年(1～14年),15例腺内型中2例死亡(13．33％),而9例腺外型中6例(66．67％)死亡;20例颈部肿物被完全切除者均生存达1年以上,而4例肿物未能彻底切除者均生存不足1年。肿瘤组织病理分型属B大细胞型的44例中,仍生存8例,其最长生存期达68个月;而滤泡Ⅱ型的3例均死于本病,最长生存期仅18个月。本组病例的1年生存率为61.54％,3年生存率为43．31％,5年生存率为27．35％。结论：原发甲状腺恶性淋巴瘤肿物彻底切除辅以治疗量的放疗和化疗是较合理的治疗方法。发病时的年龄、肿瘤的临床分型(肿瘤侵犯程度)和肿物切除是否彻底是影响原发甲状腺恶性淋巴瘤预后的主要因素;肿瘤的组织病理分型与预后无关。     

儿童淋巴瘤细胞白血病临床探讨

本文结合我院1988年11月—1993年3月收治的54例儿童淋巴瘤细胞白血病(LML)的临床资料,进行了临床分析探讨。按勇氏标准诊断。男44例,女10例,最小1岁,最大15岁。Ⅲ、Ⅳ期50例,病理类型高度、中度恶性32例(占66.7％)。临床表现除淋巴瘤及白血病常见症状、体征外,因原发部位及转移部位不同,临床表现复杂多样。骨髓增生活跃或明显活跃,粒、红、巨核系统不同程度受抑、淋巴系统恶性增生,出现特异的淋巴瘤细胞。外周血红细胞、血色素,血小板呈不同程度减少,部分病例白细胞异常增高;分类中淋巴细胞增高、或可见淋巴瘤细胞。治疗以CHOP方案化疗为主,首次CR7例,PR33例,PD9例,未治5例。近期有效率74％,CR期40天～21个月,中位缓解期6.5个月。生存时间10天～60个月,中位生存期7.5个月。讨论中指出,LML的发生与病理类型高度、中度恶性,尤其是淋巴母细胞型、免疫分型T细胞型的密切相关,纵隔病变伴胸水或淋巴细胞明显增高者与发生白血病;多组浅表淋巴结肿大、肝脾进行性肿大;晚期病例;骨髓增生明显活跃伴粒、红、巨核系统受抑者及外周血白细胞持续增多者易患白血病。儿童LML与ALL在骨髓、外周血、临床表现,临床发生发展及病理组织学方面有差别。     

儿童非霍奇金淋巴瘤90例综合治疗结果与分析

为探讨儿童非霍奇金淋巴瘤的治疗策略和合理治疗方法。按临床分期不同采用以ＣＯＰＰ,ＣＨＯＰ和ＢＡＣＯＰ方案为主的联合化疗或联合放疗的综合治疗方法。９０例儿童非霍奇金淋巴瘤,按ＡｎｎＡｒｂｏｒ临床分期,Ⅰ,Ⅱ,Ⅲ,Ⅳ期分别有１１例,３５例,１２例,３２例,其中３０例有全身症状。中、高度恶性分别有５７例和３１例,未分型２例。治疗后全组近期疗效为完全缓解（ＣＲ）５４例,部分缓解（ＰＲ）１５例,稳定（Ｓ）１例,进展（Ｐ）２０例,其中ＣＲ病例包括手术切除肿块的６例。全组的治疗后１,３,５ａ和１０ａ生存率分别为６３．３％,３８．５％,３８．５％和３４．５％。通过对不同临床分期,不同临床病理分型,有无全身症状,不同近期疗效者与治疗后长期生存率关系的分析显示,Ⅰ,Ⅱ期的长期生存率优于Ⅲ,Ⅳ期,中度恶性者优于高度恶性,无全身症状者优于有全身症状者,治疗后肿瘤完全缓解者优于部分缓解、稳定或进展的病例。结果提示,通过综合治疗,争取首程治疗达到肿瘤完全缓解是提高儿童非霍奇金淋巴瘤远期生存率的主要策略之一。     

原发性胃肠道恶性淋巴瘤预后因素分析

目的：探讨影响原发性胃肠恶性淋巴瘤预后的因素。方法：对104例原发性胃肠恶性淋巴瘤的一般情况、病理类型、分期、治疗效果与5、10年生存率的相关性进行分析。结果：具有下列因素的患者：年龄大于60岁；瘤体直径大于10cm；瘤体突破浆膜或浸润周围脏器；病理分期Ⅲ、Ⅳ期；T细胞型；未接受手术治疗；初治未达CR，与其他患者对比并经统计学分析处理，结果显示：二者的5年生存率有显著性差异（P＜0．05或P＜0．01）。结论：除IPI指标外，肿块体积、病理分期与分型、临床分期、治疗手术以及初治效果，均是影响原发性胃肠恶性淋巴瘤预后的主要因素。     

恶性淋巴瘤1126例临床特点分析

 目的　分析恶性淋巴瘤患者住院的临床特点。方法　从该院病案数据库提取2005年1月至2009年12月住院恶性淋巴瘤患者的资料,剔除未能明确病理分型及重复入院的病例,从年龄、性别、病理类型、肿瘤起病部位及分期等方面进行分析、总结。结果　住院的恶性淋巴瘤患者1126例,男女比例为1.94∶1。霍奇金淋巴瘤（HL）患者年龄集中在20～40岁,以混合细胞型（64.16 %）、结节硬化型（29.48 %）为主。非霍奇金淋巴瘤（NHL）患者年龄以50~70岁为多,发病率位于前10位的为弥漫大B细胞淋巴瘤（53.31 %）、结外NK／T细胞淋巴瘤（7.35 %）、套细胞淋巴瘤（6.40 %）、B细胞慢性淋巴细胞白血病／小淋巴细胞淋巴瘤（4.30 %）、间变性大细胞淋巴瘤（4.09 %）、前T细胞淋巴母细胞白血病／淋巴瘤（3.88 %）、外周T细胞淋巴瘤（非特指）（3.46 %）、血管免疫母细胞型淋巴瘤（3.04 %）、滤泡性淋巴瘤（2.94 %）、伯基特淋巴瘤（2.52 %）。两者起病部位均以颈部淋巴结常见。结论　HL和NHL发病存在性别、年龄、病理类型、起病部位等差异。     

儿童非霍奇金淋巴瘤53例临床分析

目的　总结 5 3例儿童非霍奇金淋巴瘤的临床特点及治疗方法。方法　回顾性分析 5 3例儿童非霍奇金淋巴瘤的临床症状、病理类型、诊断和治疗。结果　浅表淋巴结肿大为首发症状者 36例。全组误诊率 71 7%。病理类型主要为高度恶性 (31/ 5 3)。全组 5年生存率为 2 2 6 %。结论　儿童非霍奇金淋巴瘤为儿童常见肿瘤 ,恶性度高 ,误诊较为常见 ,治疗应以化疗为主配合局部放疗。     

60例HIV阴性浆母细胞淋巴瘤患者的临床特征及预后

目的 探讨HIV阴性浆母细胞淋巴瘤(PBL)的临床特征及预后.方法 搜集1997年1月1日—2020年3月30日本院及其他文献报道的HIV阴性PBL病例,使用Logistic回归分析、Kaplan-Meier法和Cox回归分析对筛选的临床特征、分子病理、治疗以及预后相对完整的病案进行分析.结果 共收集60例患者,平均年...     

原发性胃淋巴瘤28例回顾性分析

目的：探讨原发性胃淋巴瘤的诊断与治疗方法。方法：回顾性分析28例原发性胃淋巴瘤患者的临床病理资料,对其诊断、治疗及预后进行分析。结果：临床表现以上腹疼痛不适、消瘦、腹部肿块为主,术前误诊率为35.7%,5年生存率,低度恶性胃淋巴瘤为89.5%,高度恶性胃淋巴瘤为55.6%。结论：胃原发性淋巴瘤是误诊率较高的胃部少见恶性肿瘤。治疗是以手术为主的综合治疗,影响预后的主要因素有：病理分型、分期及综合治疗方案;提高对原发性胃淋巴瘤的认识及早期确诊可以提高原发性胃淋巴瘤患者的生存率。     

Primary gastrointestinal non-Hodgkin’s lymphoma: clinicopathological and prognostic analysis

The objective is to investigate the association between pathological type and clinical features, response to treatment and prognosis of primary gastrointestinal Non-Hodgkin’s lymphoma (PGINHL). The clinicopathologic features, response to treatment and survival of 124 patients with PGINHL, were investigated retrospectively. Ninety-one patients were treated with surgery, most of which included combined therapy, while 32 patients received chemotherapy alone. Survival analysis was performed by Kaplan–Meier and Cox regression method. The most common immunophenotype was B-cell subtype. In 115 (92.7%) patients of B-cell lymphoma, mucosa-associated lymphoid tissue lymphoma (MALToma) and diffuse large B-cell lymphoma (DLBCL) were 55 and 50 patients, respectively. The patients of two pathological types had different clinical features including stage, B symptoms, sites of tumor, distant involvement, International Prognosis Index Score, size of tumor, and response to treatment. Both overall survival curve and multiple Cox regression analysis indicated that pathological type was statistically significant. The pathological subtype of PGINHL was an important prognostic factor. The patients with MALToma appear to have more favorable prognosis than those with DLBCL.     

Clinical features and treatment of childhood malignant lymphoma in Uganda

A series of 66 patients with Burkitt's lymphoma or childhood lymphoma of the histiocytic or lymphoblastic type has been analysed. The six patients with histiocytic lymphomas had clinical features, response to therapy and survival rates which clearly distinguished this group from Burkitt's lymphoma. Of the six patients with lymphoblastic lymphomas, however, three presented with clinical features indistinguishable from Burkitt's lymphoma while two had facial tumors which showed atypical features. The response to chemotherapy with CTX was more favorable in the lymphoblastic than in the histiocytic group, and the survival rate in this small number of patients falls midway between those of histiocytic lymphoma and Burkitt's lymphoma. Thus, the clinical evaluation of Ugandan children with lymphoblastic lymphoma did not clearly distinguish this group from patients with Burkitt's lymphoma, and casts some doubt on the use of clinical features or response to therapy as diagnostic criteria.     

Clinical Analysis of 29 Cases with Primary Malignant Lymphoma of the Prostate

OBJECTIVE To summarize the clinical characteristics, pathology, treatment and prognosis of malignant lymphoma of the prostate. METHODS Clinical data from 29 patients with primary malignant lymphoma of the prostate were reviewed retrospectively. The median age was 66 years. Clinical signs and symptoms were due to lower urinary tract obstruction resulting from a diffusely enlarged prostate. Prostate biopsies revealed diffuse large B-cell non-Hodgkin＇s lymphoma. The therapeutic modalities included prostatectomy, radiotherapy and chemotherapy. RESULTS Extraprostatic involvement at various sites became evident in 19 of the 29 patients after diagnosis. Ten patients died from lymphoma with a median survival of 23 months （range, 2-30 months）. Seven patients were alive up to 60 months. CONCLUSION Malignant lymphoma involving the prostate was rare and has a rather poor prognosis. Prognosis related to the patient age, histologic type, and treatment or clinical stage of the disease at presentation.     

Low-grade mucosa-associated lymphoid tissue lymphoma: a retrospective analysis of 97 patients by the Hellenic Cooperative Oncology Group (HeCOG).

BACKGROUND: The aim was to examine characteristics and treatment results of patients with mucosa-associated lymphoid tissue (MALT) non-Hodgkin's lymphomas. PATIENTS AND METHODS: Epidemiological and clinical features of 97 patients with MALT lymphoma from the Hellenic Cooperative Oncology Group registry were analysed retrospectively for their prognostic significance in progression-free survival (PFS) and overall survival (OS). Comparisons were made between patients with gastric and nongastric sites of primary lymphoma and between different therapeutic modalities. RESULTS: Sixty-five patients presented with gastric and 32 with nongastric lymphomas. The most frequent locations of nongastric lymphomas were the bowel, lung and parotid. Gastric lymphomas occurred more frequently in males and younger patients compared with nongastric lymphomas. Seventy-four per cent of patients had early (Ann Arbor stages I-II) and 26% had advanced (stages III-IV) disease. The median PFS for the entire population was 44 months. At 5 years, 47% of patients were progression free and the OS rate was 80%. The most reliable prognostic factor for PFS and OS was the Ann Arbor stage; 5-year PFS was 67% versus 13% and 5-year OS 91% versus 51% for patients with early versus advanced disease, respectively (P < 0.001). Of the patients treated with chemotherapy only, 87% achieved an objective response and 71% complete response. Surgery did not offer survival benefit compared with chemotherapy in localised gastric lymphoma. CONCLUSION: MALT lymphomas represent a distinct disease entity with widespread extranodal origin, indolent clinical course and high chemosensitivity. Ann Arbor stage was the most reliable prognostic and predictive factor.     

鼻腔NK/T细胞淋巴瘤的临床特征和治疗现状

鼻NK／T细胞淋巴瘤属恶性淋巴瘤的一种少见的特殊类型，其诊断和治疗尚存在争议。本文综述了该病的流行病学、病因和发病机制、临床表现、分期、病理特征、诊断、治疗现状及预后，为提高认识、规范治疗提供线索。     

Monoclonal immunoglobulin production is a frequent event in patients with mucosa-associated lymphoid tissue lymphoma.

PURPOSE: Mucosa-associated lymphoid tissue (MALT) lymphoma comprises 7% of all newly diagnosed non-Hodgkin's lymphomas and is therefore among the most common lymphoma entities. Monoclonal gammopathy due to production of a monoclonal immunoglobulin by lymphoma cells is a well-known phenomenon associated with various types of B-cell non-Hodgkin's lymphomas. The objective of the present study was to evaluate the incidence and clinical relevance of paraprotein (PP) production in patients with MALT lymphoma. EXPERIMENTAL DESIGN: Fifty two patients were prospectively evaluated with regard to differentiation of the MALT lymphoma cells, t(11;18) translocation, monoclonal immunoglobulin production, Helicobacter pylori (HP) status, stage, treatment, and clinical outcome. RESULTS: Nineteen of 52 MALT lymphoma patients (36%) had PP (8 IgMkappa, 6 IgGkappa, 4 IgMlambda, and 1 IgAkappa). The histologic feature of plasmacytic differentiation correlated significantly with the production of PP (P = 0.001). No correlation was found between PP and clinical stage, HP status, and t(11;18) status. PP was, however, negatively associated with response to eradication of HP in gastric MALT lymphoma, and PP levels declined significantly in patients responding to chemotherapy or radiation. Importantly, both immunofixation and serum electrophoresis have to be performed to detect low PP levels. CONCLUSIONS: In conclusion, PP levels may probably be used as a potential prognostic tool for response to HP eradication, and serial measurements may also allow for noninvasive assessment of response to radiation or chemotherapy in patients with MALT lymphoma.     

原发性睾丸淋巴瘤的临床特点及预后

目的：探讨原发性睾丸淋巴瘤（primary testicular lymphoma,PTL）的临床和病理特点及其与预后的相关性关系。方法回顾性分析PTL患者33例,评价其临床和病理特点及其与预后的关系。结果33例患者中,27例为弥漫性大B细胞型,占81.8％;3例为T细胞型,占9.1％;1例为伯基特（Burkitt）型,占3.0％;未能分型者有2例,占6.1％。临床分期为Ⅰ期和Ⅱ期的患者共有28例,占84.8％;Ⅲ期和Ⅳ期的患者有5例,占15.2％。术后5年生存率为39.1％,5年无进展生存率为39.3％。预后单因素分析表明,Ann Arbor分期≥Ⅲ期、乳酸脱氢酶≥240 U/L、淋巴瘤国际预后指数≥2,以及初次治疗后未完全缓解的患者预后较差。预后多因素分析结果显示,初次治疗后达CR是影响患者预后的因素,差异具有统计学意义（P<0.05）。结论影响PTL术后的预后因素较多,临床上应采取综合疗法。     

Primary B-cell lymphoma of the skin: the Sheffield Lymphoma Group Experience (1984-2003)

The clinical presentation, treatment and outcome were retrospectively evaluated in a series of 66 patients with primary B-cell lymphoma of the skin, referred to the Sheffield lymphoma group (SLG) between 1984 and 2003. This is the largest series reported from the UK. The lymphoma database was searched and clinical records were reviewed. Absence of any detectable extracutaneous lesion and the expression of B-cell restricted antigens by neoplastic cells were the essential criteria for selection of cases. The cohort included 37 (56%) males and 29 (44%) females with a mean age of 59 years. The most commonly involved site was the trunk and the disorder typically showed non-aggressive clinical behaviour; the majority of the patients presented with stage I (82%) disease with a tendency to remain localised to a limited area of the skin. Follicular lymphoma was the most common histologic subtype (35%), the next most frequent was the diffuse large cell lymphoma (32%) whereas marginal zone lymphoma constituted 15%. The majority (47%) of patients were treated with radiotherapy for localised disease whereas chemotherapy was given in 20% of patients, with single agent chlorambucil being most frequently used. Surgical excision as the sole modality of treatment was adequate in 33%. Disease-free survival (DFS) was 91% at 1 year, 82% at 2 years and 60% at 5 years. DFS was significantly lower with older age (>45 years), leg lesions, generalised and multiple lesions, and for those treated with chemotherapy. The survival at 5 and 10 years was 80%. The histologic grade, leg involvement and the number of lesions were the most significant variables affecting overall survival. Only 7 patients died of lymphoma. In conclusion, primary cutaneous B-cell lymphoma represents a specific entity concerning clinical behaviour, response to treatment, and overall prognosis.