原发性子宫和阴道非霍奇金淋巴瘤

目的探讨原发性子宫和阴道非霍奇金淋巴瘤临床病理特点及治疗。方法回顾性分析1996年8月～2003年9月北京协和医院和江西省妇幼保健院收治的10例原发性子宫和阴道非霍奇金淋巴瘤患者的临床表现、病理特征和治疗结果。结果10例原发性子宫和阴道非霍奇金淋巴瘤患者平均发病年龄为43．5岁，分期均为IEa，发生部位：子宫颈8例、子宫底部和阴道壁各1例。临床表现为阴道分泌物增多和血性分泌物，4例患者有明确占位病变。组织病理均为B细胞淋巴瘤(CD20 )。4例为粘膜相关淋巴瘤(MALT)，4例弥漫大B细胞淋巴瘤(DLBCL)。手术治疗6例，手术方式为全子宫、双附件切除及盆腔淋巴结清扫术，其中手术 化疗5例，手术 化疗 放疗1例，单纯化疗3例，化疗 放疗1例。化疗多为CHOP方案。死亡1例，存活9例，最长生存期已84个月。结论原发性子宫和阴道非霍奇金淋巴瘤极为少见，临床表现无特异，组织病理B细胞淋巴瘤为主，根治性手术切除和联合化疗是有效的治疗方法，宫颈和阴道淋巴瘤预后较好。

Primary Non-Hodgkin''''s lymphoma of uterus and vagina

Objective To investigate the clinical and pathological features of primary Non-Hodgkin's lymphoma of uterus and vagina and to explore the methods of treatment.Methods Clinical presentation,pathological features and therapeutic results of ten cases of primary Non-Hodgkin's lymphoma of uterus and vagina from Aug 1996 to Aug 2003 were retrospectively analyzed.Results The average age of the 10 patients is 43.5 years old.All of them were IE for clinical stage,including 8 from the cervix,1 uterus corpus and 1 vaginal wall.The clinical presentation is increased vaginal discharge and bloody vaginal discharge.Four patients had definite pathological lesion.All of the patients were histologically diagnosed with B-cell lymphoma,CD20 +,4 of whom were MALT and 4 DLBCL.The treatment consisted of hysterectomy in 5 patients followed by chemotherapy,and 1 followed by chemotherapy and radiotherapy,chemotherapy alone in 3 patients,chemotherapy and radiotherapy in 1 patient.The chemotherapy regimen is CHOP.One died within 12 months after the initial diagnosis,9 patients are survival,and 1 of them is alive with disease free for 84 months.Conclusions Primary Non-Hodgkin's lymphoma of female genital tract is relatively rare without specific clinical presentation.Most of the histological type is B-cell type lymphoma.Radical surgery and combined chemotherapy may be one of the effective approaches for treatment of primary Non-Hodgkin's lymphoma of female genital tract.The patients with cervical and vaginal primary Non-Hodgkin's lymphoma show good prognosis after regular treatment.