淋巴瘤与多原发肿瘤的关系

目的 探讨淋巴瘤患者中多原发肿瘤的发病特点。方法检索1999年1月至2008年6月多原发肿瘤患者的病例。分析其中包含淋巴瘤病理诊断的病例资料。结果在2668例多原发肿瘤病例中，共检索出32例在多原发肿瘤中包括非霍奇金淋巴瘤或霍奇金淋巴瘤病例。其中30例为双原发肿瘤，2例为三原发或四原发肿瘤。男女比例为1：1。32例患者中，以淋巴瘤作为第1原发肿瘤7例，同时双原发癌5例．淋巴瘤（全部为非霍奇金淋巴瘤）作为第2、3、4原发肿瘤20例。第1和第2原发肿瘤的平均发病年龄分别为（50．4±14．7）岁和（58．4±12-2）岁，同时多原发肿瘤患者的平均年龄为（60．0±14．5）岁。非霍奇金淋巴瘤在第2、3、4原发癌中占绝对优势，比例为92．6％（25／27）。第2原发肿瘤为非霍奇金淋巴瘤病例中，B细胞来源占84％（21／25），结外器官起源占60％（15，25）。结论在以淋巴瘤作为多原发肿瘤之一的患者中。非霍奇金淋巴瘤是最主要的第2原发肿瘤，多为B细胞来源，常见结外器官起源或受侵．平均发病年龄较大。

Multiple primary tumors in patients with malignant lymphoma

Objective To analyze the characteristic of multiple primary tumors in patients with malignant lymphoma. Methods The occurrence of multiple malignancy was studied in patients with lymphoma from January1999 to Jane2008. Results Thirty two cases with primary tumors other than lymphoma were identified from 2668 multiple primary tumor cases. Male and female ratio was 1：1. Seven cases were diagnosed as lymphoma as first primary tumor, 5 cases as synchronous, and 20 cases as subsequent primary tumour（all cases were non-Hodgkin lymphoma）. The mean age of first and second primary tumor were 50.4±14.7 and 58.4±12.2 years old respectively, synchronous cases was 60.0±14.5 years old. NHL occurred premoninantly as second primary tumor, accounted for 92.6% （25/27） of all cases. Second primary NHL was most B cell origin （21/25）,84% and frequently with primary extranodal involvement （15/25）,60%. Conclusions NHL is predominantly as second or subsequent primary tumor in multiple primary tumor cases. Majority of the cases is B cell origin and with primary extranodal involvement. The mean age of patients is older.