赵静, 王华庆, 王平. 原发性卵巢淋巴瘤的临床特点及治疗[J]. 中国肿瘤临床, 2013, 40(21): 1328-1331. DOI: 10.3969/j.issn.1000-8179.20131689
引用本文: 赵静, 王华庆, 王平. 原发性卵巢淋巴瘤的临床特点及治疗[J]. 中国肿瘤临床, 2013, 40(21): 1328-1331. DOI: 10.3969/j.issn.1000-8179.20131689
Jing ZHAO, Huaqing WANG, Ping WANG. Clinical characteristics and treatment of primary ovarian malignant lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(21): 1328-1331. DOI: 10.3969/j.issn.1000-8179.20131689
Citation: Jing ZHAO, Huaqing WANG, Ping WANG. Clinical characteristics and treatment of primary ovarian malignant lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(21): 1328-1331. DOI: 10.3969/j.issn.1000-8179.20131689

原发性卵巢淋巴瘤的临床特点及治疗

Clinical characteristics and treatment of primary ovarian malignant lymphoma

  • 摘要:
      目的  探讨原发性卵巢淋巴瘤(primary ovarian lymphoma,POL)的临床特点,诊治要点及预后。
      方法  回顾性分析天津医科大学附属肿瘤医院自2000年6月至2010年5月收治的14例POL患者的临床资料,并结合国内外文献进行分析。
      结果  14例患者的中位发病年龄为47(28~62)岁,就诊时首发症状主要表现为腹痛、腹部包块、月经减少,所有病例病理证实为非霍奇金恶性淋巴瘤。病理类型以侵袭性为主(弥漫大B细胞淋巴瘤7例,滤泡性淋巴瘤2例,小淋巴细胞性淋巴瘤2例,间变性大细胞淋巴瘤1例,T细胞性淋巴母细胞淋巴瘤1例,Burkitt淋巴瘤1例)。2例单纯手术治疗(术后失访),其余患者术后行CHOP、氟达拉滨联合环磷酰胺(FC)、CHOPE等方案化疗,其中5例应用利妥昔单抗靶向治疗。截止随访之日,5例健在,6例死亡,1例失访。
      结论  POL极为罕见,与卵巢癌鉴别困难,临床易误诊。目前缺乏标准的治疗方案,采取综合治疗,术后给予蒽环类药物为主的全身化疗,B细胞淋巴瘤首选利妥昔单抗联合化疗,预防性腹腔灌注化疗和放射治疗有助于减少复发。

     

    Abstract:
      Objective  To investigate the clinical features and prognostic factors of primary ovarian lymphoma(POL).
      Methods  A retrospective review was performed based on the clinical records of 14 POL cases treated at Tianjin Medical University Oncology institute Hospital verity from 2000-6 to 2010-5.
      Results  The median age of patients was 47 years at presentation(range 28~62years). Abdominal pain was the most common initial symptom. The majority of histological subtype was B cell lymphoma, above 50% of which is diffuse large B-cell non-Hodgkin's lymphoma. A R0 resection was carried out in 2 patients who were lost to follow-up soon after surgery. 11 patients were treated by CHOP, FC or CHOPE chemotherapy. Chemotherapy combined with rituximab were given to 5 patients. Until now, 5 patients were alive, 6 patients died, and only one patient was lost to follow up after therapy.
      Conclusion  POL is an extremely rare lymphoma. The ultimate diagnosis depends on histopathologic examination. Primary ovarian non-Hodgkin lymphoma should be treated with multi-modality strategies. Treatment with doxorubicin-based chemotherapy after oophorotomy is recommended. B cell lymphoma preferred to use rituximab combination chemotherapy. Abdominal cavity chemotherapy prophylaxis and irradiation can decrease the probability for recurrence.

     

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