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目的:探讨原发性结外型淋巴瘤(PENL)的临床和病理特征。方法:回顾性分析304例PENL的病例资料,从性别、发病年龄、病理类型、起病部位等方面进行总结分析。结果:①304例PENL中位年龄51岁(3~91岁),41~70岁为高发年龄段;男女比为1.2∶1.0,原发于小肠和腮腺的好发于男性,甲状腺、扁桃体和脾则表现为女性明显多于男性。②本组PENL占同期淋巴瘤的53.0%(304/574),以非霍奇金淋巴瘤(NHL)为主,占95.1%;霍奇金淋巴瘤(HL)占4.9%。结外NHL占同期NHL的58.1%(289/497),结外HL占同期HL的19.5%(15/77)。③原发部位广泛,常见于胃肠道(25.0%)、鼻腔(12.2%)、纵膈(9.9%)、扁桃体(9.5%)。④原发于胃肠道、扁桃体、中枢神经系统、骨、乳腺、甲状腺、睾丸、子宫、卵巢、脾、肺、肾等部位的PENL病理类型,以弥漫性大B细胞淋巴瘤常见;原发于鼻腔的PENL病理类型,以结外NK/T细胞淋巴瘤常见。临床分期以Ⅰ期、Ⅱ期为主。结论:PENL发病率较高,发病部位广泛,临床表现多样且无特异性,临床中对各组织器官疾病进行诊断时应警惕淋巴瘤的可能性,尽早行组织病理学检查,避免漏诊和误诊。
Objective: To investigate the clinical and pathological features of primary extranodal lymphoma (PENL). Methods: A retrospective analysis of 304 cases of PENL case information, from the gender, age of onset, pathological type, the incidence of the site to conduct summary analysis. Results: ①304 PENL patients were 51 years old (range 3 to 91 years old) and 41 to 70 years old. The ratio of men to women was 1.2:1.0. The origin of the PENL in the small intestine and parotid gland was mainly in the male, thyroid, tonsil and spleen The performance of women significantly more than men. ② PENL in this group accounted for 53.0% (304/574) of lymphoma in the same period, which was mainly non-Hodgkin’s lymphoma (NHL), accounting for 95.1%; Hodgkin’s lymphoma (HL) accounted for 4.9%. The extranodal NHL accounted for 58.1% (289/497) of the NHL during the same period, while the extranodal HL accounted for 19.5% (15/77) of the HL during the same period. ③ a wide range of primary sites, common in the gastrointestinal tract (25.0%), nasal cavity (12.2%), mediastinum (9.9%), tonsils (9.5%). ④ primary pathological type of PENL in gastrointestinal tract, tonsil, central nervous system, bone, breast, thyroid, testis, uterus, ovary, spleen, lung, kidney and other parts of the common diffuse large B cell lymphoma; Pathological types of PENL in the nasal cavity are common in extranodal NK / T cell lymphomas. Clinical stage to stage Ⅰ, Ⅱ-based. Conclusion: The incidence of PENL is high, the incidence of a wide range of clinical manifestations and non-specific clinical diagnosis of various tissues and organs should be alert to the possibility of lymphoma, histopathological examination as early as possible to avoid misdiagnosis and missed diagnosis.