头颈部非霍奇金淋巴瘤25例临床分析

目的：探讨25例头颈部非霍奇金淋巴瘤(NHL)的临床表现、分期、分型及治疗方法。方法：对我院2000年3月-2004年4月间治疗的25例头颈部NHL进行回顾性分析。结果：25例中,首犯咽淋巴环11例,鼻腔8例,鼻窦1例,颈淋巴结4例,腮腺1例。鼻腔、鼻窦已有3例死亡。结论：根据头颈部NHL的首犯部位、肿瘤分期、组织学分型进行恰当的治疗,可提高治愈率。     

原发性头颈部非霍奇金淋巴瘤临床分析

目的 探讨原发于头颈部的非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)的临床及病理特点,为早期诊断提供经验,从而降低误诊率及漏诊率.方法 对51例原发于头颈部,经病理确诊为NHL患者的临床资料进行回顾性分析.结果 原发部位,鼻腔、鼻窦1 9例(37.3%),腭扁桃体14例(27.5%),颈淋巴结8例(15.7%),鼻咽部6例(11.8%).误诊为炎症7例(13.7%),鼻咽癌2例(3.9%),总误诊率17.6%.结论 头颈部NHL恶性程度高,多好发于鼻腔及鼻窦,其次为扁桃体.该病误诊率高,准确的取材活检及免疫组化检查至关重要.     

原发性头颈部非霍奇金淋巴瘤62例临床分析

目的 :探讨原发性头颈部非霍奇金淋巴瘤 (NHL)的临床特征。方法 :分析 6 2例头颈部NHL的临床资料。结果 :腭扁桃体 (2 5 .8% )、颈淋巴结 (19.4 % )、鼻腔及鼻窦 (12 .9% )为NHL的好发部位 ;临床分期ⅠE期和ⅡE期分别为 38.7%、2 4 .2 %。病理分型高度恶性为 75 .8%。CR率 75 .8% ,PR率 14 .5 % ,有效率 90 .3% ;部分患者无瘤长期生存。结论 :头颈部NHL一般恶性度高 ,多发于结外组织且易发生淋巴结转移 ,准确的取材活检结合免疫组化有利于早期确诊 ,治疗上应采用化疗、放疗或结合手术的综合治疗方案。     

18例头颈部非霍奇金淋巴瘤临床分析

目的：探讨头颈部非霍奇金淋巴瘤(NHL)的临床表现、病理分型、临床分期、治疗及预后。方法：18例头颈部NHL患者，7例行手术加放、化疗，11例行放、化疗。结果：完全缓解13例，部分缓解5例。除1例失访外，17例随访3～5年，均生存。结论：头颈部NHL早期诊断较难；治疗以放、化疗为主，早期放、化疗有利预后。     

头颈部非霍奇金淋巴瘤临床特征及误诊原因分析

恶性淋巴瘤是头颈部常见的恶性肿瘤之一,其中非霍奇金淋巴瘤(non Hodkinlymphoma,NHL)在头颈部的发生率远高于霍奇金病(Hodikindisease,HD)。头颈部NHL早期症状不典型,临床表现差异较大,耳鼻咽喉科医生如对此病缺乏认识,则易出现漏诊和误诊现象。为提高临床医生对该病的认识,现     

头颈部原发性淋巴结外非霍奇金氏淋巴瘤临床和细胞免疫学表型分析

目的：报告原发于头颈部淋巴结外非霍奇金氏淋巴瘤的临床及细胞免疫学表型特点,方法：回顾近十年来经病理学确诊的,原发于头颈部淋巴结外的非奇金氏淋巴瘤115例,对其临床和细胞免疫表型特征进行分析。结果;本组头颈部淋巴结外非霍奇金氏淋巴瘤发病高峰年龄段为21－40岁,原发部位鼻腔最多,其次为鼻咽,扁桃体和口腔,而口咽,下咽和喉较少,临床表现以原发器官症关为主,体征以结节状或菜花状肿块型最多,其次为肿块伴溃烂型,单纯溃烂型较少,细胞免疫学表型结果显示,来源于T细胞者占51．2％,来源于B细胞者占48．8％,其中鼻腔以T细胞淋巴瘤为主,鼻咽则T,B细胞淋巴瘤约占各一半,扁桃体和口腔则以B细胞淋巴瘤为多。结论：头颈部淋巴结外霍奇金氏淋巴瘤最常原发于鼻腔,其次为鼻咽,扁桃体和口腔,临床表现缺乏特征性,易与原发器官的其他恶性肿瘤相混淆,易造成误诊,因此必须依据病理学和免疫组化染色进行鉴别和确诊。     

原发于头颈部的结外型非霍奇金淋巴瘤42例临床分析

目的：探讨原发于头颈部的结外型非霍奇金淋巴瘤（NHL）的临床和病理特点,为该病的早期诊断提供经验。方法：对42例原发于头颈部,经病理证实为结外型NHL的患者的临床资料进行回顾性分析。结果：按照发生部位将病例分为3组,发生于扁桃体的病变与发生于鼻腔的病变之间的确诊时间差异有统计学意义（P〈0．05）;发生于扁桃体的病变与发生于鼻窦的病变之间的确诊时间差异有统计学意义（P〈0．05）;发生于鼻腔与鼻窦病变之间的确诊时间差异无统计学意义（P〉0．05）;按照有无全身症状将病例分为2组,其确诊时间之间差异无统计学意义（P〉0．05）。结论：原发于头颈部的结外型NHL病理类型恶性程度高,临床症状无特异性,其中发生于扁桃体的病变更容易被早期发现,是否伴有全身症状与确诊时间不具有相关性,对于发生于耳鼻咽喉部的单侧病变,要严密观察,必要时进行活检。     

头颈部非霍奇金淋巴瘤的临床特点

目的探讨头颈部非霍奇金淋巴瘤临床特点.方法结合相关文献的复习,回顾18例头颈部非霍奇金淋巴瘤的临床表现、诊断过程及部分CT影像.结果位于咽淋巴环多见,其次为鼻腔鼻窦;发病年龄在16～71岁之间;男女比为2∶1;18例中有11例曾被诊断为慢性炎症;CT检查均未明确提示恶性病变;从发病至确诊时间在12～500天不等.结论头颈部NHL的临床表现缺乏特异性,容易误诊;短期内进行性单侧扁桃体肿大、外观可疑者应考虑本病可能;准确的活检取材有助于最终明确诊断.     

耳鼻咽喉头颈部216例结外非霍奇金淋巴瘤的临床病理分析

目的：探讨耳鼻咽喉头颈部原发性结外非霍奇金淋巴瘤（NHL）的临床病理学特征。方法：回顾性分析216例头颈部NHL患者的临床病理学资料。结果：本组样本年龄分布有2个高发段,分别为31～60岁和71～80岁;最常见的原发部位为鼻腔95例（44．0％）,其次为扁桃体47例（21．8％）;最常见的组织学类型为NK／T细胞淋巴瘤107例（49．5％）,其次为弥漫性大B细胞淋巴瘤58例（26．7％）。按部位统计发病率最高的组织学类型分别为：鼻腔为NK／T细胞淋巴瘤74例（77．9％）,鼻窦为弥漫性大B细胞淋巴瘤6例（50．0％）,扁桃体为弥漫性大B细胞淋巴瘤27例（57．4％）,鼻咽口咽为NK／T细胞淋巴瘤17例（44．7％）,舌根为弥漫大B细胞淋巴瘤5例（45．4％）。结论：耳鼻咽喉头颈部原发性NHL是一类比较常见的疾病,其在发病年龄、原发部位和组织学类型上都具有明显的临床病理学特征,对临床病理诊断有较大的帮助。     

Control of neck nodes in squamous cell carcinoma of the head and neck by radiotherapy: prognostic factors

313 patients with cervical metastases from a squamous carcinoma of the head and neck treated with radiotherapy, were studied by means of a multivariant analysis in order to determine the prognostic factors for cure. These were: lymph node response to irradiation (P= 0.0000), size of node (P= 0.0000), radiotherapy dose (P= 0.0037), condition of the primary (controlled vs non-controlled) (P= 0.0015), recurrent cervical metastases post-surgery (P= 0.0286).     

Incidence of ‘unsuspected’ extranodal head and neck lymphoma

A series of 100 consecutive patients presenting with non-Hodgkin's lymphoma in the head and neck region was reviewed. An examination of the contribution made to the staging classification by an otolaryngological examination showed that one-third of patients presenting with cervical nodes had unsuspected extranodal disease in Waldeycr's ring. Overall 14% of patients undergoing an otolaryngological examination had their disease upstaged because of that examination.     

Hodgkin's and non-Hodgkin's lymphoma of the head and neck

OBJECTIVES/HYPOTHESIS: Lymphomas are a frequent cause of malignant lymphadenopathy in the head and neck. This study was performed to evaluate the head and neck manifestations of lymphomas and to emphasize the different presentations of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). STUDY DESIGN: Retrospective review. METHODS: A retrospective review was made of all cases of lymphomas involving the head and neck at Marshfield Clinic (Marshfield, WI) between 1988 and 1996. Specifically, the clinical presentations, staging, and prognosis for HD and NHL with head and neck involvement were sought. RESULTS: Three hundred eleven patients were included in the study, 76 with HD and 235 with NHL. The median age at diagnosis for patients with HD was 27.7 years, and for patients with NHL, 67.2 years. This difference was highly significant (P <.001). No significant difference in gender was noted, with male patients occurring in 59% with HD and 49% with NHL (P=.135). Extranodal involvement including the oral cavity, oropharynx, nasopharynx, paranasal sinuses, and larynx occurred with HD in 3 patients (4%) and with NHL in 54 patients (23% P <.001). Cervical adenopathy consisted of a single node in 24% of patients with HD and 33% of those with NHL (no significant difference, P=.236). The difference in mediastinal nodal involvement was highly significant, occurring in 65% of patients with HD and 38% of patients with NHL(P <.001). Abdominal nodes occurred in 20% of cases of HD and 45% of cases of NHL (P<.001). A significant difference in constitutional symptoms was noted with 41% of cases in HD and 27% of cases in NHL (P=.020). For the percentage of patients with stage IV disease, there was a highly significant difference by diagnosis with 10% in HD and 36% in NHL (P <.001). The median follow-up time was 51 months, and 12% of patients with HD and 41% of patients with NHL died of their disease. Both the overall survival and survival from death attributable to disease were significantly better for HD(P<.001). CONCLUSIONS: Hodgkin's disease presents at a younger age and is less common than NHL. Cervical lymphadenopathy is the most common head and neck presentation for both diseases. Associated mediastinal adenopathy was more common with HD, and abdominal adenopathy with NHL. Constitutional symptoms were more common with HD. More advanced disease with a decreased overall survival was seen with NHL.     

头颈耳鼻咽喉部原发性结外非霍奇金淋巴瘤临床和免疫组化特征

目的：探讨头颈耳鼻咽喉部原发性结外非霍奇金淋巴瘤(PE-NHL)的临床及免疫表型特征。方法：回顾性分析155例头颈耳鼻咽喉部PE—NHL患者的临床资料，采用免疫组织化学技术复阅病理片改变。结果：临床表现原发器官缺乏特异性，体征以肿块或溃烂型最多。细胞免疫表型结果显示，来源于T细胞者占46．4％，来源于B细胞者占53．6％。其中鼻腔鼻窦以T细胞淋巴瘤为主，韦氏环则以B细胞淋巴瘤为多。结论：头颈耳鼻咽喉部PE-NHL临床过程复杂，特征缺乏特异性，诊断较难。对本病提高警惕，对可疑者反复活检，依据病理学和免疫组织化学改变结合临床特征可确诊。     

84例原发头颈部淋巴瘤临床及病理特征分析

目的 探讨原发头颈部淋巴瘤的临床及病理特征。 方法 回顾性分析84例原发头颈部淋巴瘤患者的病历资料,对其年龄、性别、肿瘤部位、临床表现和病理类型及预后等进行分析。 结果 84例患者中,男性45例(53.6%),女性39例(46.4%),男女比为1.15∶1,年龄19~80岁。病理类型以非霍奇金淋巴瘤为主, 有80例(95.2%),霍奇金淋巴瘤4例(4.8%);非霍奇金淋巴瘤中弥漫大B细胞淋巴瘤39例(48.7%),NK/T淋巴瘤21例(26.3%)。发病部位广泛,依次为:颈部28例(33.3%),鼻腔鼻窦26例(30.9%),扁桃体14例(16.7%),舌根7例(8.3%)。原发于颈部淋巴结及Waldeyer 淋巴环以弥漫大B细胞淋巴瘤为主,原发于鼻腔鼻窦以NK/T细胞淋巴瘤为主。头颈部NK-T细胞淋巴瘤1年生存率为90%, 5年生存率47.6%;头颈部弥漫大B淋巴瘤1年生存率为97.3%,5年生存率58.3%。 结论 原发头颈部淋巴瘤发病率高,临床及影像学无特异性,需及早行组织病理检查,减少漏诊及误诊。