原发性胰腺淋巴瘤诊治分析:附八例

目的 总结原发性胰腺淋巴瘤的诊治经验.方法 回顾性分析2002年10月至2006年8月间复旦大学附属华山医院收治的8例原发性胰腺淋巴瘤病人资料.结果 病灶位于胰头部7例,胰体尾部1例.临床表现包括上腹痛、上腹压痛、纳差、呕吐、黄疸、腰背痛、上腹肿块、发热、体重减轻等.5例合并胰胆管扩张,其中4例血清CA19-9轻度升高,其余肿瘤指标均处于正常范围.3例行血β2-微球蛋白及乳酸脱氢酶检查,均显示升高.1例行Whipple术,并行CHOP方案与美罗华化疗;2例直接行CHOP方案与美罗华化疗;4例行姑息性肿瘤切除,其中2例术后行CHOP方案与美罗华化疗,1例仅行美罗华化疗,另1例未行化疗;1例仅行剖腹探查病灶活检术.结论 原发性胰腺淋巴瘤临床表现无特异性,辅助检查对诊断有提示作用,化疗为其主要的治疗手段,预后明显优于胰腺癌.

Diagnosis and treatment of primary pancreatic lymphoma: an analysis of 8 cases

Objective To summarize the experience in diagnosis and treatment of primary pan-creatic lymphoma. Methods The clinical data of 8 patients with primary pancreatic lymphoma treatedin our hospital from October 2002 to August 2006 were retrospectively analyzed. Results Seven tumors were located in the head of pancreas and 1 in the body and tail of pancreas. Clinical manifesta-tions included epigastric pain,epigastric tenderness,nausea and vomiting,jaundice,back pain,epigastric mass,fever,loss of weight etc. Five patients had dilatation of bile and pancreatic duct and 4 of them had slightly increase of CA19-9 in the serum while all other patients had normal level of tumor markers.Three patients had increase of β2-microglobulin and LDH in the serum. One patient underwent Whip-ple procedure,CHOP and Mabthera chemotherapy and 2 CHOP and Mabthera chemotherapy. Four patients received tumor resection and palliative operation. For these 4 patients,2 received CHOP and Mabthera chemotherapy and 1 Mabthera chemotherapy. Biopsy was performed in only 1 patient. Con-clusion The symptoms of primary pancreatic lymphoma are not specific. Its auxiliary examination can provide important information for diagnosis. Chemotherapy is the main treating tool and its prognosis is obviously superior to pancreatic cancer.