【摘要】 目的:探讨以脾大为首发表现的恶性淋巴瘤的临床病理特点及诊断方法。方法:回顾性分析24例以脾大为首发表现的恶性淋巴瘤(ML)患者的临床和病理资料。结果:以脾大为首发表现的ML患者临床表现更为复杂,主要有淋巴结肿大、发热、乏力、盗汗及体重减轻。病理类型为霍奇金淋巴瘤2例(8.3%),非霍奇金淋巴瘤22例(91.7%);B细胞淋巴瘤18例(75.0%),T细胞淋巴瘤6例(25.0%)。按照Ann/Arbor分期(Cotswolds修订)标准,本组24例ML患者中,Ⅰ期1例(4.2%),Ⅱ期1例(4.2%),Ⅲ期13例(54.1%),Ⅳ期9例(37.5%)。1年生存率为83.3%。结论:超声、CT等影像学检查对脾脏淋巴瘤的诊断有积极意义,脾切除病理检查既可明确诊断,提高早期确诊率,又有治疗的作用,但应权衡手术利弊。更多还原

【Abstract】 Objective:To investigate the clinic pathological characteristics and diagnosis of malignant lymphoma(ML) by analyzing the presentation of 24 cases with splenomegaly.Method:The clinical data of 24 cases of ML with splenomegaly at presentation were retrospectively analyzed.Result:The clinical characteristics of ML with splenomegaly were complicated but without specificity.The most usual symptom was enlargement of lymph nodes,fever, lassitude,night sweats and loss of body weight.The pathological type was composed with 2 cases of Hodgkin lymphoma(8.3%),22 cases of non-Hodgkin lymphoma(91.7%),18 cases of B cell lymphoma(75.0%) and 6 cases of T cell lymphoma(25.0%).Among the 24 cases of ML patients,1 case(4.2%),1 case(4.2%), 13 cases(54.1%) and 9 cases(37.5%) were assigned to stage Ⅰ,Ⅱ,Ⅲ and Ⅳ groups respectively according to the classification of Ann/Arbor(revised by Cotswolds).The 1 year postoperative survival rate was 83.3%.Conclusion:It is very helpful to diagnose spleen lymphoma by B ultrasonic and CT.Splenectomy and pathological examination can confirm the diagnosis,to improve early diagnosis rate,and the treatment effect,but we should weigh the advantages and disadvantages of the operation.更多还原