呼吸系统原发性淋巴瘤11例临床分析

目的了解呼吸系统原发性淋巴瘤(PLRS)的临床病理特点及治疗结果。方法分析11例患者的临床表现、影像学改变、病理类型、治疗及生存情况。结果原发于气管2例,原发于肺9例。临床表现主要为咳嗽胸闷、发热、胸片和胸部cT扫描表现为肿块或阴影。病理类型为霍奇金(HD)2例;非霍奇金淋巴瘤(NHL)9例,包括低度恶性7例,其中黏膜相关淋巴瘤5例(55．6％),中度恶性2例。10例行手术治疗,8例术后加化疗,2例术后加放疗。治疗后2例HD患者的无病生存期超过5年,黏膜相关淋巴瘤和其它类型的NHL中位生存期分别为39个月和34个月。结论PLRS的临床和影像学表现为非特异性,病理类型以低度恶性黏膜相关淋巴瘤多见,外科手术为治疗首选,预后良好。

Primary Lymphoma of Respiratory System (A Report of 11 Cases)

Objective: To analyze the clinical and pathologic features and the treatment outcomes of primary lymphoma of respiratory system (PLRS). Methods: The clinical manifestation, imaging changes, pathologic subtypes, treatment and overall survival of 11 patients with PLRS were analyzed retrospectively. Results: Of the 11 patients diagnosed with PLRS by histopathology, the tumor of 2 patients occurred in trachea and the other 9 in lung. Cough, dyspnea and fever were the most frequent symptoms. Mass or infiltrative changes could be found on the chest X-ray and/or CT scan. Two patients were diagnosed as having Hodgkins Lymphoma (HL) and 9 having non-Hodgkins Lymphoma (NHL), including 7 patients with low degree NHL 5 of them (55.6%) were mucosa-associated lymphoid tissue (MALT) lymphoma] and 2 with intermediate degree NHL. Of 10 patients undergoing exploratory thoracotomy and surgical treatment, 8 received adjuvant chemotherapy and 2 adjuvant of radiotherapy. The remaining patient was subjected to combined chemotherapy. Both of HL patients survived more than 5 years without clinical disease. The median survival of MALT lymphoma and other type of NHL was 39 months and 34 months respectively. Conclusion: Both the clinical manifestation and imaging changes are non-specific. The diagnosis was made through exploratory thoracotomy (10 cases) and fiber-optical bronchoscopy (1 case). MALT lymphoma is the most frequent pathologic subtype. Majority of patients are diagnosed and treated by surgical resection. The prognosis is acceptable.