5例牙龈非霍奇金淋巴瘤(NHL)的临床病理学特点

 目的  报道5例原发于牙龈的非霍奇金淋巴瘤(non-Hodgkin′s lymphoma,NHL),探讨其临床病理特点及预后转归情况。方法  分析5例牙龈NHL的临床特点,组织病理学类型及特点,并随访其治疗情况与预后结局。结果  牙龈NHL约占口腔NHL的4.6%,比较罕见,以中老年男性为主,临床表现缺乏特异性,初诊漏/误诊率达80%,国际预后指数(international prognostic index,IPI)评分均在2分以上。其中3例接受化疗加放疗,1例仅化疗,1例未治疗,平均生存期34个月。组织病理学类型多样,其中NK/T细胞型2例,结外边缘区黏膜相关型1例,弥漫大B细胞型1例,外周T细胞型1例,Ki67增值指数以弥漫大B细胞型与外周T细胞型较高,结外边缘区黏膜相关型较低。结论  原发牙龈NHL比较罕见,初诊时易漏误诊,多种类型均可发生,总体预后不佳。

Clinicopathologic characteristics of gingival non-Hodgkin′s lymphoma (NHL) in 5 cases

Objective    To report 5 cases of primary gingival non-Hodgkin′s lymphoma (NHL) and discuss their clinicopathologic characteristics and prognosis.Methods   The clinical characteristics,histological types and features in the 5 cases of gingival NHL were analyzed.Their treatment details and prognosis were also followed.Results    Gingival NHL was rare, which represented 4.6% of the total oral NHL, with a significant male and elder predilection. It did not show any specific clinical presentations with a misdiagnosis or missed diagnosis rate of 80%. All of them showed higher international prognostic index (IPI) score above 2. Among them, 3 cases received combined radio chemotherapy and 1 case received chemotherapy, but 1 case received nothing. The mean survival was 34 months. Various histological types were found, including 2 cases of NK/T cell type, 1 case of mucosa associated lymphoid tissue of extranodal marginal zone type, diffuse large B cell type, and peripheral T cell type respectively. The proliferative index of Ki67 was higher in diffuse large B cell and peripheral T cell types and lower in mucosa associated lymphoid tissue of extranodal marginal zone tpye.Conclusions    Primary gingival NHL was rare with a higher misdiagnosis or missed diagnosis rate.Various histological types could occur with a total poor prognosis.