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目的探讨不一致性淋巴瘤的临床病理特征。方法采用形态学观察、免疫组化及分子病理学方法,对1例不一致性颈部淋巴结弥漫大B细胞淋巴瘤和鼻咽非特异性外周T细胞淋巴瘤进行临床病理分析,并复习文献。结果患者以鼻咽部肿物为首发症状,第1次鼻咽肿物活检诊断为非霍奇金淋巴瘤,T细胞性;之后进行颈部淋巴结活检,诊断为弥漫大B细胞淋巴瘤。进行了8个疗程的R-CHOP方案化疗后患者病情进展,重新取鼻咽肿物活检,诊断为非特异性外周T细胞淋巴瘤。最终诊断为同时发生的不一致性淋巴瘤。结论不一致性B细胞和T细胞淋巴瘤非常罕见,从每一个病变部位取活检有助于避免漏诊,从而选择正确的治疗方案。
Objective To investigate the clinicopathological features of incongruent lymphoma. Methods The morphological, immunohistochemical and molecular pathological methods were used to analyze the clinicopathological features of one case of inconsistent cervical lymph node diffuse large B-cell lymphoma and nasopharyngeal nonspecific peripheral T-cell lymphoma and to review the literature. Results The patient had nasopharyngeal tumor as the first symptom. The first nasopharyngeal biopsy was diagnosed as non-Hodgkin’s lymphoma and T-cell lymphoma. Then, cervical lymph node biopsy was performed to diagnose diffuse large B-cell lymphoma. Eight courses of R-CHOP regimen chemotherapy patients progress, re-take nasopharyngeal biopsy, diagnosis of non-specific peripheral T cell lymphoma. The final diagnosis of coincident non-uniform lymphoma. Conclusions Inconsistent B-cell and T-cell lymphomas are rare and taking a biopsy from each lesion can help avoid missed diagnosis and thus select the right regimen.