不典型恶性淋巴瘤三例误诊原因分析

目的分析不典型恶性淋巴瘤3例误诊原因,总结防范措施。方法回顾性分析误诊为其他疾病的不典型恶性淋巴瘤3例的临床资料。结果3例均因发热就诊,病初均行相关检查未能明确诊断,分别误诊为结核性心包炎、胃体黏膜慢性炎伴溃疡、泌尿系感染,均予对症处理,病情无明显好转。为进一步明确诊断行穿刺活检,1例确诊为霍奇金淋巴瘤,2例确诊为非霍奇金淋巴瘤,给予对症治疗,其中1例完成化疗后临床治愈,1例化疗过程中出现肾损伤于半年后死亡,1例治疗18个月后病情复发死亡。结论不典型恶性淋巴瘤临床表现特征不明显,不易鉴别诊断,提示临床应提高警惕,避免误诊。

Misdiagnosis of Atypical Malignant Lymphoma:Analysis of 3 Cases

Objective To analyze the causes of misdiagnosis in 3 cases of atypical malignant lymphoma,and to summarize the preventive measures.Methods A retrospective analysis was made on clinical data of 3 cases of atypical malignant lymphoma misdiagnosed as other diseases in our hospital.Results Three patients were hospitalized for fever,and the relevant examinations of the disease in early stage failed to confirm the diagnosis.Three cases were misdiagnosed as tuberculous pericarditis,chronic inflammation of gastric body mucosa with ulcers,and urinary tract infections,all of which were treated symptomatically without any significant improvement.To further confirm the diagnosis,pathological biopsy was performed to make diagnosis of typical Hodgkin lymphoma in 1 case and non-Hodgkin lymphoma in the other two cases.After symptomatic treatment,one patient finished chemotherapy and was cured in clinical settings,one patient died half a year later because of renal injury during chemotherapy,and one died 18 months after chemotherapy because of recurrence.Conclusion Atypical malignant lymphoma has no obvious clinical manifestations and is difficult to differentiate and diagnose,therefore,we should be vigilant to avoid misdiagnosis.