原发性气管B细胞淋巴瘤3例报道并文献复习

目的:回顾并分析32例原发气管B细胞淋巴瘤的诊疗过程，探讨原发气管淋巴瘤的最佳诊疗模式。方法:回顾我院2016年11月至2017年5月收治的3例病理明确的原发气管B细胞淋巴瘤患者的临床资料，并检索国内外期刊相似病案29例，对其临床症状、气管镜下表现、治疗方式以及随访时间进行分析，探讨气管B细胞淋巴瘤治疗方式的选择。结果:32例确诊患者中男性12例，女性20例；发病年龄31~83岁；前期症状不典型，以咳嗽、气喘等多见，少部分因“呼吸困难”急诊入院。气管镜下见气管单发或多发结节，不同程度堵塞管腔，病理类型均为黏膜组织相关性B细胞淋巴瘤。其治疗方式多样，包括手术、放化疗、内镜治疗以及上述方式的多种组合，效果普遍较好，生存期较长，随访一般状况良好。结论:气管B细胞淋巴瘤的治疗多推荐手术及放化疗，但随着内镜技术的发展，以及患者接受度高的优势，作者认为气管镜下介入治疗联合或不联合化疗可能是不良反应小、效果好且易于被患者接受的一种最佳治疗模式，但需要更多样本数据来支持。

Three cases of primary tracheal B cell lymphoma and literature review

Objective:To explore the optimal treatment mode for primary tracheal B cell lymphoma according to the review and analysis of 32 cases.Methods:Three patients with confirmed primary tracheobronchial lymphoma of Anhui Chest Hospital from November 2016 to May 2017 were analyzed retrospectively,and 29 similar cases reported in published papers were also collected.The clinical symptoms,imaging features,treatment methods and follow-up time were analyzed to invest the best treatment model for B cell lymphoma.Results:In 32 patients,the age was from 31 to 83 years old.12 patients were male,and 20 patients were female.Most patients had non-typical early symptoms,like cough and asthma.Some patients had emergency visits due to dyspnea.The single or multiple nodules were further examined under tracheoscope,and the pathological pattern was reported as B cell lymphoma.The treatments of B cell lymphoma were different,like surgery,radiotherapy,chemotherapy,endoscopic therapy,and the combination of those methods.Conclusion:The curative effect of B cell lymphoma is better in general,and the patients usually have long lifetimes.With the development of the tracheoscope technique,the author thinks that the combination of chemotherapy and endoscopic therapy is a best treatment pattern,which has a curative effect with slight side effects.However,there are still need more date to support this opinion.