以深静脉血栓为首发表现的非霍奇金淋巴瘤二例并文献复习

 目的 提高对非霍奇金淋巴瘤（NHL）伴深静脉血栓（DVT）形成的认识，减少临床漏诊、误诊，增加预防意识。方法 通过二例病例并结合文献复习，对该病的发生率、发病机制、治疗以及预防进行讨论和分析。结果 二例NHL均以下肢浮肿为首发症状，经淋巴结病理确诊为滤泡型淋巴瘤（B细胞来源），Ann Arbor分期为Ⅳb；超声确诊静脉栓塞（DVT）。接受化疗及抗凝的组合疗法后，1例获得完全缓解（CR），1例部分缓解（PR），DVT均消失。结论 DVT可为NHL的首发表现，并可出现于淋巴结肿大前数月，而且NHL伴DVT形成的发生率较低，临床上极易漏诊、误诊。发病机制尚不明确。治疗方法主要为化疗的同时加用抗凝治疗。

Two patients with non-Hodgkin lymphoma and deep venous thrombosis and literature review

Objective To increase the identification of non-Hodgkin lymphoma (NHL) with deep venous thrombosis(DVT), reduce the misdiagnosis and improve the awareness of prophylaxis. Methods Com-bined with literatures review, the incidence, pathogenesis, treatment and prophylaxis were analyzed. Results The primary symptoms of 2 patients infected with NHL is edema of lower extremity. Then the diagnosis was made 1 month and 10 months respectively through lymphaden biopsy. DVT was confirmed by Doppler sonog-raphy. After receiving chemotherapy and anticoagulant therapy, one patient achieved complete remission and the other achieved partial remission. At the same time, DVT faded. Conclusion DVT can be the primary symptoms of NHL, and several months later lymphnode swell appear. The incidence of NHL with DVT is very low. Misdiagnosis can occur easily. The pathogenesis of NHL with DVT is not very clear. The major treatment for it is the combining therapy of chemotherapy and anticoagulant therapy.