原发性乳腺弥漫性大B细胞淋巴瘤13例临床分析

目的 探讨原发性乳腺弥漫性大B细胞淋巴瘤（PB-DLBCL）的临床特征、诊断和治疗。方法 回顾性分析2010年1月至2015年11月13例PB-DLBCL患者的临床资料。13例均接受手术治疗，其中4例行乳腺癌改良根治术，1例行单侧乳腺切除术，8例行乳腺肿块切除术。结果 13例均为女性，6例发生于右乳，6例发生于左乳，1例发生于双乳。肿块大小1.5 cm～8.0 cm。术前2例诊断为乳腺纤维腺瘤，1例诊断为巨纤维瘤，10例诊断为乳腺癌。13例患者均经免疫组化检测确诊为PB-DLBCL。Ann Arbor分期：Ⅰ期10例,Ⅱ期3例。12例术后给予CHOP或R-CHOP方案化疗，1例放弃治疗。随访1个月～5年，2例复发，2例死亡，其余病例均无复发生存。结论 PB-DLBCL临床少见，多见于女性。术前检查、术中冰冻病理检查易误诊，免疫组化检查可明确诊断。治疗采用以化疗为主的综合治疗。

Clinical analysis of 13 patients with primary breast diffuse large B cell lymphoma

Objective To explore the clinical features,diagnosis and treatment of 13 patients with primary breast diffuse large B cell lymphoma ( PB-DLBCL) . Methods The clinical data of 13 patients with PB-DLBCL from Jan 2010 to Nov 2015 were retro-spectively analyzed. Eight cases received breast mass excision, 4 cases underwent modified radical mastectomy, and 1 case received u-nilateral mastectomy. Results All of the cases were female. The involved breasts were left-sided in 6 cases, right-sided in 6 cases, and bilateral breast was found in 1 case. The size ranged from 1. 5 cm to 8. 0 cm. Two cases were preoperatively diagnosed as breast fi-broadenoma, 1 case as giant fibroadenoma, and 10 cases as breast carcinoma. Thirteen cases were diagnosed as PB-DLBCL by using immunohistochemistry. According to Ann Arbor staging, 10 cases were in stageⅠ, and 3 cases were in stageⅡ. Twelve cases received chemotherapy of CHOP or R-CHOP regimen after operation, and 1 case gave up treatment. The follow-up time ranged from 1 month to 5 years. During follow-up, 2 cases relapsed, 2 cases died, and 9 cases survived without relapse. Conclusion PB-DLBCL is not common in clinic, and mainly occurs in female. PB-DLBCL is easily misdiagnosed by preoperative examination and intraoperative frozen section, and the exact diagnosis is confirmed by immunochemistry. Chemotherapy based comprehensive treatment is the main method for PB-DLBCL.