原发性腹膜后恶性淋巴瘤的诊治

目的:总结探讨原发性腹膜后恶性淋巴瘤的诊断及治疗。方法:回顾性分析我院1995~2005年收治的48例经手术或穿刺活检组织病理学确诊的原发性腹膜后恶性淋巴瘤的临床资料及诊治情况。结果:术前B超引导下穿刺活检8例,组织病理学检查确诊5例,未能确诊3例,40例术前未行穿刺活检,经手术后切除之标本行组织病理学检查确诊或术中活检确诊。48例中接受手术治疗45例,其中单纯肿瘤切除1例,肿瘤联合多脏器切除29例,肿瘤姑息性切除8例,剖腹探查手术活检7例。术后并发症7例,术后死亡1例。3例未行手术直接化疗。结论:原发性腹膜后恶性淋巴瘤一般不主张手术治疗,对于临床表现、影像学检查怀疑者,应避免盲目手术,尽量采取微创方法获取深部组织进行组织病理学诊断,根据组织学诊断决定进一步治疗方案。

Diagnosis and management of primary malignant retroperitoneal lymphoma

Objective:To discuss the diagnosis and management of primary malignant retroperitoneal lymphoma. Methods:A retrospective search of 48 cases who were diagnosed pathologically as primary malignant retroperitoneal lymphoma during 1995-2005 in our hospital. Results: 8 cases underwent ultrasonic-guided needle biopsy, 5 of which were pathologically diagnosed, 3 were not; 40 cases were pathologically diagnosed by operation or intraoperative biopsy. 45/48 of cases underwent surgery, including 1 case for tumor excision, 29 cases for underwent tumor and multiple organs excision, 8 cases for palliative escision, 7 cases for laparotomy biopsy. 7 cases had postoperative complication, 1case died perioperative. 3 cases received chemotherapeutic management directly. Conclution:Surgical management is not the best choice for primary malignant retroperitoneal lymphoma. For those whose clinical sysnptom and image examining were suspect, minimally invasive procedures to get deep organ masses for the diagnosis should be taken, and the subsequent management should based on the histological diagnosis.