以急性胰腺炎为首发症状的胰腺淋巴瘤临床特征研究

目的 提高对以急性胰腺炎为首发症状的胰腺淋巴瘤的认识.方法 回顾性分析7例胰腺淋巴瘤的症状、体征、实验室检查、临床诊治及转归,复习相关文献.结果 7例患者均以急性腹痛为主要临床表现,血尿淀粉酶及脂肪酶升高,影像学提示不同程度胰腺受累,5例伴胰腺外淋巴结、骨、骨髓、脾等多部位侵犯.7例均确诊为非霍奇金淋巴瘤,其中6例为弥漫大B细胞淋巴瘤,1例间变大细胞淋巴瘤.除1例放弃治疗外,6例接受ECHOP或RCHOP方案化疗,其中2例死亡,4例达完全缓解或部分缓解,随访中.结论 胰腺淋巴瘤以急性胰腺炎为首发症状临床少见,病情复杂,确诊有赖于组织病理学检查,应尽早诊断,治疗包括急性胰腺炎常规治疗及联合化疗.

Clinical study of pancreatic lymphoma presenting as acute pancreatitis

Objective To analyze the clinical features and diagnosis-treatment of pancreatic lymphoma presenting as acute pancreatitis.Methods The clinical records of 7 patients including laboratory findings were retrospectively reviewed.Some related medical literatures were reviewed.Results Seven patients presented acute abdominal pain.Laboratory findings revealed significant increase of serum amylase and lipase levels.CT scan of the abdomen or PET-CT showed a diffuse swelling of the pancreas or masses in the body or tail.Extrapancreatic spread such as bone,bone marrow,spleen infiltrate was found out in 5 patients.Of the 7 patients,6 were diagnosed as the diffuse large B-cell lymphoma,1 as the anaplastic large cell lymphoma.Six patients underwent systematic chemotherapy.Two died and the others received complete or part remission.Conclusion Pancreatic lymphoma is uncommon and represents a rare cause of acute pancreatitis.It needs to be confirmed by histopathologic examination.The standard treatment is not only for acute pancreatitis,but also for NHL including CHOP or CHOP-like chemotherapy.