王彬, 王波, 初向阳, 张连斌. 外科手术在原发肺黏膜相关淋巴瘤中的诊治作用[J]. 中国肿瘤临床, 2013, 40(19): 1192-1195. DOI: 10.3969/j.issn.1000-8179.20131440
引用本文: 王彬, 王波, 初向阳, 张连斌. 外科手术在原发肺黏膜相关淋巴瘤中的诊治作用[J]. 中国肿瘤临床, 2013, 40(19): 1192-1195. DOI: 10.3969/j.issn.1000-8179.20131440
Bin WANG, Bo WANG, Xiangyang CHU, Lianbin ZHANG. Surgical resection for the diagnosis and treatment of primary pulmonary mucosa-associated lymphoid tissue lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(19): 1192-1195. DOI: 10.3969/j.issn.1000-8179.20131440
Citation: Bin WANG, Bo WANG, Xiangyang CHU, Lianbin ZHANG. Surgical resection for the diagnosis and treatment of primary pulmonary mucosa-associated lymphoid tissue lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(19): 1192-1195. DOI: 10.3969/j.issn.1000-8179.20131440

外科手术在原发肺黏膜相关淋巴瘤中的诊治作用

Surgical resection for the diagnosis and treatment of primary pulmonary mucosa-associated lymphoid tissue lymphoma

  • 摘要:
      目的  探讨原发肺黏膜相关淋巴组织(MALT)淋巴瘤的临床特点、影像学特征、治疗方法及其预后。
      方法  回顾性分析解放军总医院2000年4月至2012年7月收治的13例肺MALT淋巴瘤患者的临床、影像学和随访资料。
      结果  13例肺MALT淋巴瘤患者中,男8例,女5例,男女比例1.6∶1;发病年龄21~67岁,中位年龄59岁。主要临床表现为胸部不适6例,咳嗽2例,发热2例,胸痛1例,还有2例无明显不适症状;有1例合并有干燥综合征。胸部CT表现为3例有肺实变影伴有支气管充气征,3例有斑片影,4例中出现团块影,还有3例可见磨玻璃结节影,其中10例患者表现为双肺均有病变,另有4例伴有纵隔淋巴结肿大,1例伴有胸腔积液。6例行手术治疗,其中3例术后辅以化疗,4例患者单纯行化疗,方案主要为CHOP方案或R-CHOP方案,3例患者仅行对症支持治疗。13例中1例失访,随访时间1~11年。1例于确诊4年后出现疾病进展,并于11年后死亡,1例因化疗不良反应于确诊后2年内死亡,余10例至今仍生存,且无疾病进展。
      结论  肺MALT淋巴瘤的临床表现不典型,影像学缺乏特异性改变,确诊依靠病理学检查。对于那些病变局限,尤其是常规方法无法取得病理的患者,手术切除病灶既能明确诊断,又能使患者获得良好的治疗效果,在该病的诊治过程中起到了重要的作用。该病预后较好。

     

    Abstract:
      Objective   To discuss the clinical and imaging features as well as the treatment and prognosis of primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma.
      Methods   We retrospectively analyzed the clinical, imaging, and follow-up data of 13 patients with pulmonary MALT lymphoma in the Chinese PLA General Hospital from April 2000 to July 2012.
      Results   Of the 13 patients with pulmonary MALT lymphoma, 8 were male and 5 were female (1.6:1 ratio). The age of onset varies from 21 years to 67 years, and the median age is 59 years. The major clinical manifestations include chest discomfort in 6 cases, cough in 2 cases, fever in 2 cases, and chest pain in 1 case. Two cases had no observable discomfort. One patient suffered from Sj?gren's syndrome. The chest CT of the patients showed pulmonary consolidation with air bronchogram in 3 cases, patchy shadows in 3 cases, mass shadow in 4 cases, and ground-glass opacities in 4 cases. In addition, 10 cases showed bilateral pulmonary multiple changes, 4 showed mediastinal lymph node enlargement, and 1 showed pleural effusion. Operation was performed on 6 patients, 3 of which were given postoperative adjuvant chemotherapy. Four patients underwent chemotherapy involving the CHOP or R-CHOP regimen, whereas three patients received symptomatic and supportive treatment only. One case was lost to follow-up. The follow-up period ranged from 1 year to 11 years. In one patient, the disease progressed four years after the diagnosis, and the patient died after 11 years. One patient died from the side effects of chemotherapy. The remaining 10 cases were still alive and did not show any progression of the disease.
      Conclusion   The clinical feature of pulmonary MALT lymphoma is not typical. Thus, imaging techniques cannot detect specific changes. Surgical resection is vital in the diagnosis and treatment of this disease because it can help provide a clear diagnosis, particularly to patients with limited lesions and from which specimens could not be obtained using conventional methods. Moreover, the prognosis of this treatment is generally good.

     

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